双侧腹横肌平面联合腹直肌鞘阻滞用于完全腹膜外腹腔镜腹股沟疝修补术的临床研究  

Clinical study of application of bilateral transverse abdominal plane block combined with rectus sheath block in totally extraperitoneal prothetic inguinal hernia repair

作　　者：黎裕星 莫平 黎铨初 邓双钊 郑映金 梁秀萍 彭为平 LI Yu-xing(Department of anesthesiology,people's hospital of Nanhai district in Foshan city,Foshan,Guangdong,528200,China)

机构地区：[1]佛山南海区人民医院麻醉科,广东佛山528200

出　　处：《齐齐哈尔医学院学报》2020年第8期943-945,共3页Journal of Qiqihar Medical University

基　　金：佛山市医学科研基金资助(20180241)。

摘　　要：目的分析TR(双侧腹横肌平面联合腹直肌鞘阻滞)用于TEP(完全腹膜外腹腔镜腹股沟疝修补术)的临床价值。方法选择2018年1月—2019年10月本院收治的80例TEP手术患者作为研究对象,随机分为研究组和对照组两组,每组各40例。研究组患者进行TR阻滞,对照组患者进行T(腹横肌平面阻滞)阻滞,对比两组术中瑞芬太尼用量、术后不同时间静息、运动状态下VAS评分、BCS评分、患者满意度以及不良反应发生情况。结果研究组术中瑞芬太尼用量显著比对照组低,研究组术后1 h、6 h、12 h、24 h静息、运动状态下VAS评分显著比对照组低,研究组术后1 h、6 h、12 h、24 h BCS评分显著比对照组高,研究组患者满意度(95.00%)明显高于对照组(70.00%),差异均具有统计学意义(P<0.05)。研究组不良反应发生率(5.00%)与对照组(7.50%)比较,差异无统计学意义(P>0.05)。结论TEP手术中实施TR阻滞,可取得显著的镇痛效果,减少术中镇痛药物用量,提高患者舒适度,且不良反应较少,值得借鉴。Objective Analysis of the clinical value of TR(bilateral transverse abdominal plane block combined with rectus sheath block)for treating TEP(totally extraperitoneal prothetic inguinal hernia repair).Methods The included cases were 80 patients with TEP who underwent surgery from January 2018 to October 2019.The patients were randomly divided into 2 groups.40 patients in the study group underwent TR block,and 40 patients in the reference group underwent T blocking(transverse abdominis plane block).The dose of remifentanil in the two groups,VAS score under resting and exercise conditions at different time after surgery,BCS score,patient satisfaction and adverse reactions of the two groups were compared.Results The amount of remifentanil in the study group was significantly lower than that in the reference group.The VAS scores in the study group at 1 h,6 h,12 h,and 24 h at the condition of rest and exercise were significantly lower than those in the reference group.The BCS scores in study group at 1 st h,6 th h,12 th h and 24 th after surgery in the study group were significantly higher than the reference group.The satisfaction of the study group(95.00%)was significantly higher than that of the reference group(70.00%),the difference was statistically significant,P<0.05.There was no significant difference in th incidence of adverse reactions in the study group(5.00%)and the reference group(7.50%),P>0.05.Conclusions The implementation of TR block in TEP surgery could achieve significant analgesic effect,reduce the amount of intraoperative analgesic drugs,improve patient comfort,and have fewer adverse reactions.

关 键 词：腹横肌平面阻 完全腹膜外腹腔镜腹股沟疝修补术 双侧腹横肌平面联合腹直肌鞘阻滞 疼痛 舒适度 

分 类 号：R656.21[医药卫生—外科学]