超声引导腹横肌平面阻滞联合肺保护性通气管理策略对全麻老年腹部手术后肺部并发症的影响  

Effect of ultrasound-guided transverse abdominis plane block combined with lung protective ventilation management strategy on postoperative pulmonary complications in elderly patients treated with abdominal surgery under general anesthesia

作　　者：王娟 顾尔伟[2] 王涛 WANG Juan;GU Er-wei;WANG Tao(Department of Anesthesiology,Huaibei Miners General Hospital of Anhui Province,Huaibei Anhui 235000;Department of Anesthesiology,The First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230032,China)

机构地区：[1]安徽省淮北矿工总医院麻醉科,安徽淮北235000 [2]安徽医科大学第一附属医院麻醉科,安徽合肥230032

出　　处：《蚌埠医学院学报》2021年第1期50-53,共4页Journal of Bengbu Medical College

基　　金：安徽省重点研究和开发计划项目(1804h08020267)。

摘　　要：目的:探讨超声引导下腹横肌平面阻滞联合肺保护性通气管理策略对全麻老年腹部手术病人术后肺部并发症的影响。方法:选取择期全麻下行腹部手术的老年病人100例,随机分成对照组(C组)和超声下腹横肌平面阻滞联合肺保护性通气策略组(PT组),每组50例。观察记录2组病人术后肺部并发症发生率,气管拔管时间、PACU停留时间、术后胃肠通气时间、术后下床活动时间、术后住院时间、麻醉诱导、术中阿片类药物用量,术后6、12、24、48 h的VAS评分。结果:PT组病人术后肺部并发症发生率明显低于C组病人(P<0.01),术后下床活动时间、术后住院时间均短于C组病人(P<0.05),术中瑞芬太尼用量,术后6、12 h的VAS评分低于C组病人(P<0.05和P<0.01),2组病人的气管拔管时间,PACU观察时间,术后胃肠通气时间,麻醉诱导、术中舒芬太尼用量,术后24、48 h的VAS差异均无统计学意义(P>0.05)。结论:腹横肌平面阻滞联合肺保护性通气管理策略可显著减少全麻老年腹部手术病人术后肺部并发症的发生。Objective:To investigate the effects of ultrasound-guided transverse abdominis plane block combined with lung protective pulmonary ventilation management strategy on postoperative pulmonary complications in elderly patients treated with abdominal surgery under general anesthesia.Methods:A total of 100 elderly patients treated with abdominal surgery under general anesthesia were randomly divided into the control group(group C)and group PT(treated with ultrasound transabdominal muscle plane block combined with lung protective ventilation strategy)(50 cases each in group).The incidence rates of postoperative pulmonary complications in two groups were observed and recorded.The tracheal extubation time,PACU residence time,postoperative gastrointestinal ventilation time,postoperative activity time out of bed,postoperative hospitalization time,anesthesia induction,intraoperative opioid dosage,and VAS scores after 6 h,12 h,24 h and 48 h of surgery were analyzed in two groups.Results:The incidence rate of postoperative pulmonary complications in group PT was lower than that in group C(P<0.01),the postoperative activity time out of bed and postoperative hospital stay in group PT were shorter than those in group C(P<0.05),and the intraoperative fentanyl dosage and VAS scores after 6 h and 12 h of operation in PT group were lower than those in group C(P<0.05 and P<0.01).The differences of the tracheal extubation time,PACU observation time,postoperative gastrointestinal ventilation time,anesthesia induction,intraoperative sufentanil dosage,and VAS scores after 24 h and 48 h of operation between two groups were not statistically significant(P>0.05).Conclusions:Transverse abdominis plane muscle block combined with lung protective ventilation management strategy can significantly reduce the incidence of postoperative pulmonary complications in elderly patients treated with abdominal surgery under general anesthesia.

关 键 词：腹部手术 腹横肌平面阻滞 肺保护性通气 老年 肺部并发症 

分 类 号：R656[医药卫生—外科学]