超声引导腹横肌阻滞联合喉罩在小儿腹腔镜手术中的应用价值  

Application Value of Ultrasound-guided Transverse Abdominal Muscle Block Combined with Laryngeal Mask in Children Laparoscopic Surgery

作　　者：张婵娟[1] 邹润林 黄理进[1] 陈海林[1] 利鸿胜[1] 莫朴[1] 邹振飞[1] ZHANG Chanjuan;ZOU Runlin;HUANG Lijin;CHEN Hailin;LI Hongsheng;MO Pu;ZOU Zhenfei(Maoming People’s Hospital,Maoming 525000,China;不详)

机构地区：[1]广东省茂名市人民医院,广东茂名525000 [2]广东省高州市第二人民医院

出　　处：《中国医学创新》2020年第15期42-46,共5页Medical Innovation of China

基　　金：茂名市科技计划项目(2018221)。

摘　　要：目的:研究超声引导腹横肌阻滞联合喉罩运用于小儿腹腔镜手术中的价值。方法:选取本院2018年8月-2019年8月行腹腔镜腹股沟斜疝修补术及鞘膜积液鞘状突高位结扎术的80例腹股沟斜疝患儿。按随机数字表法分为对照组与研究组,各40例。研究组采用超声引导腹横肌阻滞联合喉罩麻醉,对照组给予喉罩麻醉。比较两组不同时间点生命体征、疼痛程度、手术、苏醒时间、Cravero量表躁动评分,并比较两组家属满意情况。结果:T0时,两组SpO2、HR、MAP及熵指数比较,差异均无统计学意义(P>0.05);T1、T2、T3时,研究组上述各指标均优于对照组,差异均有统计学意义(P<0.05)。苏醒时,两组FLACC评分比较,差异无统计学意义(P>0.05);术后2、4、8、12 h,研究组FLACC评分均低于对照组,差异均有统计学意义(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05)。研究组苏醒时间及Cravero评分均低于对照组,差异均有统计学意义(P<0.05)。研究组家属总满意率为95.00%,明显高于对照组的77.50%,差异有统计学意义(P<0.05)。结论:超声引导腹横肌阻滞联合喉罩运用于小儿腹腔镜手术中效果显著,可有效稳定患儿生命体征,减轻疼痛,防止躁动现象产生,缩短苏醒时间,患儿家属的满意度较高,值得临床推广使用。Objective:To study the value of ultrasound-guided transverse abdominal muscle block combined with laryngeal mask in laparoscopic surgery in children.Method:A total of 80 children with indirect inguinal hernia who underwent laparoscopic inguinal hernia repair and high ligation of the sheathing process with hydrocele were selected from August 2018 to August 2019.According to the random number table method,the patients were divided into control group and study group,40 cases in each group.The study group was treated with ultrasound-guided transverse abdominal muscle block combined with laryngeal mask anesthesia,and the control group was treated with laryngeal mask anesthesia.The vital signs,pain degree,operation time,recovery time,Cravero scale restlessness score at different time points were compared between the two groups,and the satisfaction of the family members of the two groups was compared.Result:At T0,SpO2,HR,MAP and entropy index of the two groups were compared,there were no significant differences(P>0.05).At T1,T2 and T3,the above indexes in the study group were better than those in the control group,and the differences were statistically significant(P<0.05).When waking up,the FLACC scores of two groups were compared,there was no significant difference(P>0.05).At 2,4,8 and 12 hours after operation,the FLACC scores of the study group were lower than those of the control group,and the difference were statistically significant(P<0.05).There was no significant difference in operation time between two groups(P>0.05).The recovery time and Cravero score of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).The total satisfaction rate of family members in the study group was 95.00%,significantly higher than 77.50%in the control group,the difference was statistically significant(P<0.05).Conclusion:The application of ultrasound-guided transverse abdominal muscle block combined with laryngeal mask in children’s laparoscopic surgery has significant effec

关 键 词：腹腔镜手术 超声引导腹横肌阻滞 喉罩 

分 类 号：R726.1[医药卫生—儿科]