超声引导下腹横肌平面阻滞在小儿疝气手术中的临床应用  

Clinical Application of Ultrasound-guided Transverse Abdominal Muscle Plane Block in Pediatric Hernia Surgery

作　　者：宫玉晶 GONG Yujing(Maternity and Infant Hospital of Yingkou Economic and Technological Development Zone,Yingkou 115007,China)

机构地区：[1]辽宁省营口经济技术开发区妇婴医院,辽宁营口115007

出　　处：《中国医药指南》2020年第31期118-119,共2页Guide of China Medicine

摘　　要：目的研究采用超声引导之下进行腹横肌平面阻滞应用在小儿疝气手术当中所取得的效果,以便为临床的麻醉工作提供可行的依据。方法2017年2月至2018年8月,选择在此期间来我院进行治疗的疝气患儿92例为研究对象,以奇偶数方法分为观察组和对照组,奇数组为观察组,偶数组为对照组,每组患者均为46例。对所有患儿进行临床诊断确诊之后,均采用小儿疝气手术方法治疗,对照组采用常规麻醉方案进行基础麻醉,观察组在基础麻醉以后进行超声引导之下腹横肌平面阻滞,对两组调查对象麻醉的情况进行评价和比较。结果观察组麻醉优良42例,麻醉优良率为91.30%,对照组麻醉优良34例,麻醉优良率为73.91%,P<0.05,存在统计学差异;观察组麻醉不良反应6例,不良反应发生率约13.04%,对照组麻醉不良反应17例,发生率为36.96%,P<0.05,差异存在统计学意义;对两组调查对象切皮以后的MAP和HR进行比较,观察组MAP为(88.2±2.4)mm Hg,对照组为(90.6±3.2)mm Hg,观察组HR为(102.2±10.5)次/分,对照组为(114.5±13.8)次/分,观察组患儿的维持状况优于对照组,P<0.05;比较两组研究对象的术中KLS合剂使用量、术后苏醒时间、术后疼痛评分,观察组分别为(2.4±0.7)mL、(22.4±4.5)min、(1.8±0.6)分,对照组分别为(3.2±0.8)mL、(35.8±5.4)min、(3.5±1.1)分,观察组的情况明显优于对照组,P<0.05,差异存在统计学差异性。结论对小儿疝气手术患儿在常规麻醉之上通过超声引导之下进行腹直肌平面阻滞有效的提升麻醉优良率,降低麻醉风险对患儿的影响,稳定患儿的各项生命体征,促进麻醉效果的提高。Objective To study the effect of transversus abdominis plane block under ultrasound guidance in pediatric hernia surgery,in order to provide a feasible basis for clinical anesthesia.Methods From February 2017 to August 2018,92 children with hernia who came to our hospital for treatment during this period were selected as the research objects.The odd and even number method was used to divide the observation group and the control group,and the odd group was the observation group.The even group wes the control group,each group has 46 patients.After clinical diagnosis and confirmation of all children,all children were treated with pediatric hernia surgery.The control group was treated with conventional anesthesia plan for basic anesthesia,and the observation group received ultrasound-guided transversus abdominis plane block after basic anesthesia.The anesthesia situation wes evaluated and compared.Results In the observation group,42 cases had excellent anesthesia,with an excellent anesthesia rate of 91.30%,and 34 cases in the control group had an excellent anesthesia rate,with an excellent anesthesia rate of 73.91%,P<0.05,there was a statistical difference;the observation group had 6 cases of adverse anesthesia,and the incidence of adverse reactions was about 13.04%,17 cases of adverse reactions to anesthesia in the control group,the incidence was 36.96%,P<0.05,the difference was statistically significant;the MAP and HR of the two groups of survey subjects after skin incision were compared,and the MAP of the observation group was(88.2±2.4)mm Hg,the control group is(90.6±3.2)mm Hg,the observation group's HR is(102.2±10.5)times/min,and the control group is(114.5±13.8)times/min.The maintenance status of the observation group is better than the control group,P<0.05.The intraoperative KLS mixture usage,postoperative wake-up time,and postoperative pain scores of the two groups were compared.The observation group was(2.4±0.7)mL,(22.4±4.5)min,(1.8±0.6)points,the control group were(3.2±0.8)mL,(35.8±5.4)min,(3.5±1.1)

关 键 词：小儿疝气 超声引导 腹横肌平面阻滞 

分 类 号：R726[医药卫生—儿科] R656.21[医药卫生—临床医学]