改良多点法腹横肌平面阻滞在腹部手术中的应用  

Application of modified multi-point method for transversus abdominis plane block in abdominal surgery

作　　者：邹夏禹[1] 冯宝莹[1] 陈海铭[1] 罗兢聪 杜杰强 ZOU Xia-yu;FENG Bao-ying;CHEN Hai-ming;LUO Jing-cong;DU Jie-qiang(Department of Anesthesiology,Foshan Hospital of Traditional Chinese Medicine,Guangdong Province,Foshan528000,China)

机构地区：[1]广东省佛山市中医院麻醉科,广东佛山528000

出　　处：《中国当代医药》2021年第19期141-143,147,共4页China Modern Medicine

基　　金：广东省佛山市卫生和计生局医学科研课题(20190083)。

摘　　要：目的探讨改良多点法腹横肌平面阻滞(TAPB)在腹部手术中的应用效果。方法选取2019年1月—2020年11月佛山市中医院麻醉科收治的60例需接受腹部手术治疗的患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各30例。观察组予以改良多点法TAPB复合全身麻醉,对照组予以单纯全麻处理,比较两组患者经不同方式麻醉后临床状况。结果观察组术后2 h(T_(1))、术后4 h(T_(2))、术后12 h(T_(3))及术后24 h(T_(4))视觉模拟疼痛评分法评分均低于对照组,差异有统计学意义(P<0.05)。观察组术后住院时间、尿管拔出时间、肛门首次排气时间、医学康复时间以及流质饮食时间均短于对照组,差异有统计学意义(P<0.05)。观察组切皮时及拔管后收缩压、舒张压以及心率指标改变水平均低于对照组,差异有统计学意义(P<0.05)。结论临床中需接受腹部手术患者,通过开展改良多点法TAPB复合全麻,能够减轻患者术后不同时间段疼痛程度,同时还能缩短患者住院时间、尿管拔出时间、肛门首次排气时间、医学康复时间以及流质饮食时间,提高患者治疗安全性,稳定患者不同时段血压水平及心率。Objective To investigate the application effect of modified multi-point method for transverse abdominis plane block(TAPB)in abdominal surgery.Methods A total of 60 patients who received abdominal surgery in the Department of Anesthesiology of Foshan Hospital of Traditional Chinese Medicine from January 2019 to November 2020 were selected as the research objects and divided into the observation group and the control group according to the random number table method,with 30 cases in each group.The observation group was treated with improved multi-point TAPB combined with general anesthesia,while the control group was treated with simple general anesthesia.The clinical status of patients in the two groups after different anesthesia was compared.Results The visual pain scale scores of the observation group at 2 h(T_(1)),4 h(T_(2)),12 h(T_(3))and 24 h(T_(4))postoperatively were lower than those of the control group,and the differences were statistically significant(P<0.05).The postoperative hospitalization time,catheter extraction time,first anal exhaust time,medical recovery time and fluid diet time in the observation group were all shorter than those in the control group,and the differences were statistically significant(P<0.05).The change levels of systolic blood pressure,diastolic blood pressure and heart rate indexes in the observation group were lower than those in the control group during skin cutting and after extubation,and the differences were statistically significant(P<0.05).Conclusion In clinical patients needing abdominal surgery,modified multi-point method for TAPB combined with general anesthesia can significantly reduce the pain degrees of patients in different time periods,and simultaneously,can also shorten hospital stay,urinary catheter extraction time,first anus exhaust time,medical recovery time and fluid diet time,which can improve the safety of patients and stabilize patients'blood pressure and heart rate in different time periods.

关 键 词：腹部手术 改良多点法腹横肌平面阻滞 全麻 疼痛程度 

分 类 号：R614[医药卫生—麻醉学]