前庭大腺切除术中会阴区超声引导选择性神经阻滞的应用效果  

Effect of ultrasound-guided selective nerve block in perineal area during resection of vestibular glandular resection

作　　者：陈娟[1] 黄源 吴青 徐玉 刘永贤 CHEN Juan;HUANG Yuan;WU Qing;XU Yu;LIU Yong-xian(Department of Anesthesiology,Changsha Central Hospital Affiliated to the University of South China,Hu′nan Province,Changsha 410007,China)

机构地区：[1]南华大学附属长沙中心医院麻醉科,湖南长沙410007

出　　处：《中国当代医药》2021年第27期80-83,共4页China Modern Medicine

摘　　要：目的探讨前庭大腺切除术中会阴区超声引导选择性神经阻滞的应用效果。方法选取2019年3月至2021年3月长沙中心医院妇产科收治的84例前庭大腺囊肿患者为研究对象,采用随机数字表法将其分为观察组(42例)和对照组(42例)。观察组行会阴区超声引导选择性神经阻滞,对照组行椎管内麻醉,比较两组麻醉前后血流动力学指标变化、围手术期视觉模拟评分法(VAS)评分、术后并发症总发生率和术后恢复时间。结果麻醉前,两组患者收缩压、舒张压、心率和VAS评分比较,差异无统计学意义(P>0.05)。麻醉后30 min,两组患者的收缩压、舒张压和心率低于麻醉前,差异有统计学意义(P<0.05)。麻醉后60 min,两组患者收缩压、舒张压和心率均高于麻醉前和麻醉后30 min,差异有统计学意义(P<0.05);观察组麻醉后30、60 min的收缩压、舒张压和心率低于对照组,差异有统计学意义(P<0.05)。麻醉后12 h,两组患者VAS评分低于麻醉前,差异有统计学意义(P<0.05)。麻醉后24 h,两组患者VAS评分高于麻醉前和麻醉后12 h,差异有统计学意义(P<0.05)。观察组麻醉后12、24 h的VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率为16.67%,低于对照组的45.2%,差异有统计学意义(P<0.05)。观察组术后恢复时间短于对照组,差异有统计学意义(P<0.05)。结论前庭大腺切除术中会阴区超声引导选择性神经阻滞患者血流动力学较为稳定,效果确切,止痛效果更佳,同时可降低手术并发症,缩短术后恢复时间,利于患者恢复,值得临床广泛应用。Objective To observe the effect of selective nerve block guided by ultrasound in perineum during vestibular glandular resection.Methods A total of 84 patients with vestibular great gland cyst admitted to the Department of Obstetrics and Gynecology of Changsha Central Hospital from March 2019 to March 2021 were selected as the research subjects,and they were divided into observation group(42 cases)and control group(42 cases)by random number table method.The observation group received perineal ultrasound-guided selective nerve block,and the control group received spinal anesthesia.Hemodynamic indexes,perioperative visual analog scale(VAS)score,total incidence of postoperative complications and postoperative recovery time were compared between the two groups before and after anesthesia.Results Before anesthesia,there were no significant differences in systolic blood pressure,diastolic blood pressure,heart rate and VAS score between two groups(P>0.05).30 min after anesthesia,systolic blood pressure,diastolic blood pressure and heart rate of patients in both groups were lower than before anesthesia,the differences were statistically significant(P<0.05).60 min after anesthesia,systolic blood pressure,diastolic blood pressure and heart rate in two groups were higher than those before and 30 min after anesthesia,the differences were statistically significant(P<0.05).The systolic blood pressure,diastolic blood pressure and heart rate of the observation group were lower than those of the control group 30 and 60 min after anesthesia,the differences were statistically significant(P<0.05).At 12 h after anesthesia,VAS scores in both groups were lower than those before anesthesia,the differences were statistically significant(P<0.05).24 h after anesthesia,VAS scores of the two groups were higher than those before and 12 h after anesthesia,the differences were statistically significant(P<0.05).The VAS score of the observation group at 12 and 24 h after anesthesia was lower than that of the control group,the differences were stat

关 键 词：前庭大腺切除术 超声 选择性神经阻滞 椎管内麻醉 

分 类 号：R614.4[医药卫生—麻醉学]