腰方肌阻滞联合全身麻醉对经皮肾镜取石术患者痛敏反应及术后恢复的影响  

F^ffects of lateral lumbar block combined with general anesthesia on pain sensitivity and postoperative recovery in patients undergoing percutaneous nephrolithotom

作　　者：周颖[1] 陈强[2] Zhou Ying;Chen Qiang(Department of Anesthesiology,Guangxi Yulin Red Cross Hospital,Yulin 537000,China;Department of Radiology,Guangxi Yulin Red Cross Hospital,Yulin 537000,China)

机构地区：[1]广西玉林市红十字会医院麻醉科,537000 [2]广西玉林市红十字会医院放射科,537000

出　　处：《国际泌尿系统杂志》2021年第1期56-59,共4页International Journal of Urology and Nephrology

摘　　要：目的观察腰方肌阻滞联合全身麻醉对经皮肾镜取石术患者痛敏反应及术后恢复的影响。方法选取2016年1月至2020年1月期间本院收治的2000例结石直径>2 cm的肾结石患者,均予以标准经皮肾镜取石术治疗。按照不同的手术麻醉方式,将患者分为A组(腰方肌阻滞联合全身麻醉)和B组(全身麻醉),每组各1000例。观察分析两组患者的术中血压变化、舒芬太尼用量与麻醉时间、术中脉率、血红蛋白、镇痛补救率及恢复时间,并观察两组患者的痛敏反应、结石清除率及并发症情况。结果B组患者的麻醉时间长于A组,舒芬太尼用量大于A组,镇痛补救率高于A组,术后第1天的疼痛评分明显高于A组,差异均有统计学意义(P<0.05);A组术中低血压发生率低于B组(P<0.05);A组术中90 min时的收缩压(SBP)与舒张压(DBP)以及脉率与麻醉前比较,差异无统计学意义(P>0.05);B组术中90 min时的SBP、DBP与脉率高于麻醉前(P<0.05);A、B两组患者术后结石清除率、术后发热率比较,差异均无统计学意义(P>0.05)。结论对肾结石患者行经皮肾镜取石术治疗中,采取全身麻醉与腰方肌阻滞联合全身麻醉的效果相近,但腰方肌阻滞联合全身麻醉在明显减少麻醉药用量、降低镇痛补救率的同时,不会对患者的血压与脉率造成不良影响,促进患者恢复,值得临床推广。Objective To observe the effects of combined anesthesia of quadrasia lumbosum block and general anesthesia on pain sensitivity and postoperative recovery in patients undergoing percutaneous nephrolithotomy.Methods From January 2016 to January 2020,2000 patients with kidney stones with diam eter of >2 cm admitted to our hospital were selected as the obsenation objects.They were all given standard percutaneous nephrolithotomy.According to the admission order,the patients were divided into group A(quadrate lumbar muscle block combined with general anesthesia)and group B(general anesthesia),with 1000 cases in each group.The intraoperative blood pressure changes,sufentanil dosage and anesthesia time,intraoperative pulse rate,hemoglobin,analgesic recovery rate,recovery time,and observe the hyperalgesia,stone clearance rate and complications of the two groups were observed and analyzed.Results The anesthesia time of patients in group B was longer than that of group A,the dosage of sufentanil was greater than that of group A,the analgesic salvage rate was higher than that of group A,and the pain score on the first day after surgery was significantly higher than that of group A,the difference was statistically significant(P<0.05).The incidence of intraoperative hypotension in group A was lower than that in group B(P<0.05).There was no statistically signifirant difference in SBP,DBP and pulse rate between group A and group b at 90 min(P>0.05).The SBP,DBP and pulse rate of group B at 90 min were higher than those before anesthesia(P<0.05).There was no statistically significant difference in postoperative calculus clearance rate and postoperative fever rate between the two groups(P>0.05).Conclusions In the treatment of percutaneous nephrolithotomy for patients with kidney stones,general anesthesia and quadratus lumbar muscle block combined with general anesthesia have similar effects,hut quadratus lumbar muscle block combined with general anesthesia can significantly reduce the amount of anesthetics and reduce analgesic reme

关 键 词：肾造口术 经皮 麻醉 全身 腰方肌阻滞 痛敏反应 

分 类 号：R614[医药卫生—麻醉学]