超声引导下腹横肌平面(TAP)阻滞联合腹直肌鞘阻滞在尿毒症患者腹膜透析置管术中的应用观察  

Application of ultrasound-guided transverse abdominal plane(TAP)block combined with rectus sheath block in peritoneal dialysis catheterization in uremic patients

作　　者：陈康福 钟绍东 彭石秀 Chen Kangfu;Zhong Shaodong;Peng Shixiu(The People's Hospital of Yudu County,Yudu,Jiangxi342300)

机构地区：[1]于都县人民医院,江西于都342300

出　　处：《基层医学论坛》2021年第35期5041-5043,共3页The Medical Forum

基　　金：赣州市指导性科技计划项目(GZ2020ZSF590)。

摘　　要：目的探讨超声引导下腹横肌平面(TAP)阻滞联合腹直肌鞘阻滞在尿毒症患者腹膜透析置管术中的应用效果。方法采用随机数字表法对60例2020年5月—2021年4月在于都县人民医院接受腹膜透析置管术的尿毒症患者进行分组,各30例,对照组接受局部浸润麻醉,观察组接受超声引导下TAP阻滞联合腹直肌鞘阻滞麻醉。对患者麻醉后30 min、60 min、6 h的疼痛视觉模拟评分法(VAS)评分变化情况、平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))水平进行观察。结果观察组麻醉后30 min、60 min、6 h的VAS评分明显较对照组低(P<0.05)。观察组的SpO_(2)水平明显较对照组高,且MAP、HR水平明显较对照组低(P<0.05)。结论超声引导下腹横肌平面阻滞联合腹直肌鞘阻滞在尿毒症患者腹膜透析置管术中的应用具有良好效果,可减轻疼痛,改善平均动脉压、心率、血氧饱和度,值得推广。Objective To investigate the effect of ultrasound-guided transverse abdominal plane(TAP)block combined with rectus sheath block in peritoneal dialysis catheterization in uremic patients.Methods 60 uremic patients who underwent peritoneal dialysis catheterization in our hospital from May 2020 to April 2021 were divided into groups by random number table method.The control group received local infiltration anesthesia,and the observation group received ultrasound-guided tap block combined with rectus sheath block anesthesia.The patients'pain visual analogue scale(VAS)was used 30 minutes,60 minutes and 6 hours after anesthesia The changes of score,mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SpO_(2))were observed.Results The visual analogue scale(VAS)scores of pain 30 min,60 min and 6 h after anesthesia in the observation group were significantly higher than those in the control group(P<0.05).The blood oxygen saturation(SpO_(2))level in the observation group was significantly higher than that in the control group,and the mean arterial pressure(MAP)and heart rate(HR)levels were significantly lower than those in the control group(P<0.05).Conclusion The application of ultrasound-guided transverse abdominal muscle plane block combined with rectus sheath block in peritoneal dialysis catheterization in uremic patients has good effect,reduces pain,improves mean arterial pressure,heart rate and blood oxygen saturation,which is worthy of great application in clinic.

关 键 词：尿毒症 腹膜透析置管术 超声引导 腹横肌平面阻滞 腹直肌鞘阻滞 

分 类 号：R692.5[医药卫生—泌尿科学]