腹横肌平面阻滞联合静脉多模式镇痛用于腹式全子宫切除术术后镇痛的研究  

Study on the Application of Transverse Abdominal Plane Block Combined with Intravenous Multimodal Analgesia in Postoperative Analgesia of Abdominal Hysterectomy

作　　者：闫俊香[1] 张建华[1] 林海波[1] YAN Junxiang;ZHANG Jianhua;LIN Haibo(Zhaoqing First People’s Hospital,Zhaoqing 526000,China;不详)

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526000

出　　处：《中国医学创新》2020年第10期36-40,共5页Medical Innovation of China

摘　　要：目的:分析腹横肌平面(TAP)阻滞联合静脉自控(PCIA)多模式镇痛用于腹式全子宫切除术术后镇痛的效果。方法:选择2017年2月-2018年6月在本院行全麻下子宫切除的患者78例为研究对象,按照随机数字表法将其分成观察组和对照组,每组39例。观察组手术后结束于超声下行双侧TAP阻滞,并开展PCIA;对照组仅使用PCIA。比较两组手术前后的呼吸频率、血氧饱和度(SpO2)、疼痛视觉模拟评分(VAS)及下床时间、住院时间、术后排气时间、镇痛满意度和不良反应发生情况。结果:术前,两组的呼吸频率及SpO2水平比较,差异均无统计学意义(P>0.05);术后,观察组的呼吸频率及SpO2水平均优于对照组,差异均有统计学意义(P<0.05)。术后2、4、8、12 h,观察组VAS评分均低于对照组,差异均有统计学意义(P<0.05)。观察组的下床时间、住院时间及术后排气时间均短于对照组,差异均有统计学意义(P<0.05)。观察组的镇痛满意度为97.44%,高于对照组的79.49%,差异有统计学意义(P<0.05)。观察组不良反应发生率为7.69%,低于对照组的28.21%,差异有统计学意义(P<0.05)。结论:在全麻下腹式全子宫切除术后联合使用TAP阻滞与PCIA多模式镇痛效果显著,对患者术后呼吸的影响更小,能提升术后镇痛效应,减少不良反应出现,有利于其身体康复,满意度更高,值得采用。Objective:To analyze the effect of transversus abdominis plane(TAP)block plus patient-controlled intravenous analgesia(PCIA)after total abdominal hysterectomy.Method:A total of 78 patients who underwent subtotal hysterectomy under general anesthesia in our hospital from February 2017 to June 2018 were selected as the study objects.According to the radom number table method,they were divided into the observation group and the control group,39 cases in each group.In the observation group,bilateral TAP block was performed by ultrasound after surgery and PCIA was performed.The control group used only PCIA.Respiratory rate and blood oxygen saturation(SpO2),visual analogue pain score(VAS)before and after surgery,time to get out of bed,hospital stay,postoperative exhaust time,analgesic satisfaction and adverse reactions were compared between the two groups.Result:Before surgery,the respiratory rate and SpO2 level of the two groups were compared,the differences were not statistically significant(P>0.05).After the operation,the respiratory rate and SpO2 level of the observation group were better than those of the control group,the differences were statistically significant(P<0.05).2,4,8,12 h after surgery,VAS scores in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The out-of-bed time,hospital stay and postoperative exhaust time of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).The analgesic satisfaction of the observation group was 97.44%,higher than 79.49%in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 7.69%,compared with 28.21%in the control group,the difference was statistically significant(P<0.05).Conclusion:After total abdominal hysterectomy under general anesthesia,TAP block combined with PCIA multi-mode analgesia has a significant effect,which has less impact on postoperative resp

关 键 词：多模式镇痛 子宫切除术 腹横肌平面阻滞 术后镇痛 不良反应 

分 类 号：R614[医药卫生—麻醉学]