超声引导下腹横肌平面阻滞(侧入法)在腹膜透析置管术中的应用  

Application of Ultrasound-guided Transversus Abdominis Plane Block(Lateral Approach)in Peritoneal Dialysis Catheterization

作　　者：熊英 XIONG Ying(Jingdezhen First People’s Hospital,Jiangxi Province,Jingdezhen 333000,China)

机构地区：[1]江西省景德镇市第一人民医院,江西景德镇333000

出　　处：《中国医学创新》2022年第30期124-127,共4页Medical Innovation of China

基　　金：景德镇市科技计划项目(20201SFZC004)。

摘　　要：目的:探讨超声引导下腹横肌平面阻滞(侧入法)在腹膜透析置管术中的应用。方法:从2020年8月-2022年6月在景德镇市第一人民医院行腹膜透析置管术的患者中,选取60例患者进行回顾性分析,根据不同的麻醉方法分为对照组和观察组,各30例。对照组麻醉方式为局部浸润麻醉,观察组麻醉方式为超声引导下腹横肌平面阻滞麻醉,比较两组患者的疼痛视觉模拟评分法(VAS)评分、血流动力学指标、不良反应发生情况。结果:观察组术后0.5、1、6 h的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。麻醉前,两组平均动脉压(MAP)、心率(HR)比较,差异均无统计学意义(P>0.05);术后30 min,观察组的MAP、HR均明显低于对照组,差异均有统计学意义(P<0.05)。观察组的不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论:在腹膜透析置管术中,超声引导下腹横肌平面阻滞可缓解术后疼痛,改善血流动力学指标,安全性较高,建议临床推广。Objective:To investigate the application of ultrasound-guided transversus abdominis plane block(lateral approach)in peritoneal dialysis catheterization.Method:From August 2020 to June 2022,60 patients who underwent peritoneal dialysis catheterization in Jingdezhen First People’s Hospital were selected for retrospective analysis.According to different anesthesia methods,they were divided into control group and observation group,with 30 cases in each group.The control group was anesthetized by local infiltration anesthesia,while the observation group was anesthetized by ultrasound-guided transversus abdominis plane block anesthesia.The pain visual analogue scale(VAS)score,hemodynamic indexes and adverse reactions were compared between the two groups.Result:The VAS scores of the observation group were lower than those of the control group at 0.5,1 and 6 h after operation,and there were statistical significance(P<0.05).Before anesthesia,there were no significant differences in mean arterial pressure(MAP)and heart rate(HR)between the two groups(P>0.05).At 30 min after operation,the MAP and HR of the observation group were significantly lower than those of the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:Ultrasound-guided transabdominis plane block can relieve postoperative pain and improve hemodynamic parameters during peritoneal dialysis catheterization,which is safe and recommended for clinical promotion.

关 键 词：腹膜透析 超声引导 腹横肌平面阻滞 

分 类 号：R614[医药卫生—麻醉学]