不同神经阻滞方法在腹股沟疝气手术中的比较  

Comparative Analysis of Different Nerve Block Methods in Surgical Repair of Inguinal Hernia

作　　者：郝帅[1] 陈延英 HAO Shuai;CHEN Yan-ying(Department of Anesthesiology,Beijing YouAn Hospital,Capital Medical University,Beijing,100069 China;Department of Anesthesiology,Air Force Characteristic Medical Center,Beijing,100142 China)

机构地区：[1]首都医科大学附属北京佑安医院麻醉科,北京100069 [2]空军特色医学中心麻醉科,北京100142

出　　处：《中外医疗》2020年第3期72-74,92,共4页China & Foreign Medical Treatment

摘　　要：目的探讨腹横肌平面阻滞与腰方肌阻滞两种不同阻滞方法在腹股沟疝修补术中的镇痛效果。方法方便选择2018年4月-2019年5月在空军特色医学中心行择期行腹股沟疝患者60例,年龄30~65岁,体重50~80 kg, ASA分级Ⅰ或Ⅱ级,所有患者根据随机表分为两组;腹横肌平面阻滞组(A组,n=30)和腰方肌阻滞组(B组,n=30)。A组采用腹横肌平面阻滞方法,而B组采用腰方肌阻滞方法,记录术前、切皮、探查疝囊和缝皮时候的Wong-baker面部表情量表评分和Ramsay镇静评分;记录术中、术后采取补救性镇痛措施的情况及发生并发症的情况。结果在Wong-baker评分比较上腰方肌阻滞组和腹横肌平面阻滞在探查疝囊和缝皮时分别是[(2.4±0.8)分∶(1.3±0.3)分(t=7.050,P<0.001)]和[(1.9±0.4)分∶(1.1±0.3)分(t=8.760,P<0.001)],显示腰方肌阻滞组具有更好的镇痛效果。结论腹股沟疝气修补术中采用腰方肌阻滞组的镇痛效果明显优于腹横筋膜平面阻滞的镇痛效果。Objective The paper attempts to make a comparative analysis of the analgesic effect produced by transversus abdominis plane block and quadratus lumbar muscle block in surgical repair of inguinal hernia Comparative. Methods Convenient selected 60 patients who underwent elective inguinal hernia at the Air Force Medical Center from April 2018 to May 2019. who were 30-50 years old and weighed between 50-80 kg were waiting for surgical repair of inguinal hernia.They had I or II ASA grade. And they were randomly divided into two groups which respectively consists of 30 patients: the group A received transversus abdominis plane block;and the group B received quadratus lumbar muscle block. Doctors recorded the Wong-Baker Faces Rating Scale scores of the patients before the operation, and during the skin incision, detection of hernial sac and suturing phases, as well as Ramsay sedation scores. The doctors also recorded the remedial analgesic measures taken during and after the operation, as well as complications from the operation. Results In the Wong-baker score, the upper quadratus lumborum block group and the musculus trasversus abdominis block were [(2.4±0.8)points∶(1.3±0.3)points(t=7.050,P<0.001)]and [(1.9±0.4)points∶(1.1±0.3)points(t=8.760,P<0.001)]at the time of investigating the hernia sac and the suture, suggesting quadratus lumborum block group has a better analgesic effect. Conclusion In surgical repair of inguinal hernia, quadratus lumbar muscle block produces an obvious analgesic effect than transversus abdominis plane block.

关 键 词：腰肌 腹肌 腹股沟疝 

分 类 号：R614[医药卫生—麻醉学]