肋缘下TAP阻滞联合LMA全麻在老年男性腹股沟疝患者中的应用效果  

Application Effect of TAP Block under Costal Margin Combined with LMA General Anesthesia in Elderly Male Patients with Inguinal Hernia

作　　者：张强[1] ZHANG Qiang(Public Security Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Traditional Chinese Medicine,Gong’an 434300,China)

机构地区：[1]湖北中医药大学附属公安中医医院,湖北公安434300

出　　处：《中外医学研究》2022年第33期56-59,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨肋缘下腹横肌平面(TAP)阻滞联合喉罩(LMA)全麻在老年男性腹股沟疝患者中的应用效果。方法:选取2018年7月-2021年6月湖北中医药大学附属公安中医医院收治的110例老年男性腹股沟疝患者。根据随机数字表法将其分为观察组与对照组,每组55例。两组均给予喉罩全麻,观察组在上述基础上给予肋缘下TAP阻滞。比较两组临床指标,术后2、6、12、24 h镇痛效果,术前及术后1 d炎症因子及应激指标,不良反应。结果:观察组术后苏醒时间早于对照组(P<0.05),丙泊酚用量少于对照组(P<0.05)。术后2、6、12、24 h,观察组动态和静态视觉模拟评分法(VAS)评分均低于对照组(P<0.05)。术后1 d,观察组白介素-6(IL-6)、C反应蛋白(CRP)、皮质醇(Cor)水平均低于对照组,促甲状腺激素(TSH)水平高于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:肋缘下TAP阻滞联合LMA全麻能够减少麻醉药物的使用,有效镇痛,减轻体内应激、炎症反应,促进患者康复。Objective:To investigate the application effect of transversus abdominis plane(TAP)block under costal margin combined with laryngeal mask airway(LMA)general anesthesia in elderly male patients with inguinal hernia.Method:From July 2018 to June 2021,110 elderly male patients with inguinal hernia admitted to Public Security Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Traditional Chinese Medicine were selected.According to the method of random number table,they were divided into observation group and control group,with 55 cases in each group.Both groups were given LMA general anesthesia,and the observation group was given TAP block under costal margin on the basis of the above.The clinical indexes,analgesic effect at 2,6,12 and 24 hours after operation,inflammatory factors and stress indicators before and 1 day after operation,and adverse reactions of the two groups were compared.Result:The postoperative recovery time of the observation group was earlier than that of the control group(P<0.05),and the dosages of Propofol was less than that of the control group(P<0.05).At 2,6,12 and 24 hours after operation,the scores of dynamic and static visual analogue scale(VAS)in the observation group were lower than those in the control group(P<0.05).One day after operation,the levels of interleukin-6(IL-6),C-reactive protein(CRP)and cortisol(Cor)in the observation group were lower than those in the control group,and the level of thyroid stimulating hormone(TSH)was higher than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The TAP block under costal margin combined with LMA general anesthesia can reduce the use of anesthetic drugs,effectively relieve pain,reduce stress and inflammatory reaction in the body,and promote the recovery of patients.

关 键 词：肋缘下TAP阻滞 LMA全麻 腹股沟疝 麻醉 应用效果 

分 类 号：R614[医药卫生—麻醉学]