彩超引导下双侧腹横肌平面阻滞复合双侧腹直肌鞘阻滞在消化道穿孔患者中的应用效果  

Application of color Doppler ultrasound-guided bilateral transverse abdominal muscle plane block combined with bilateral rectus abdominis sheath block in patients with gastrointestinal perforation

作　　者：刘津平 李斌 张梅巧 彭斌 LIU Jin-ping;LI Bin;ZHANG Mei-qiao(The People's Hospital of Ningdu County,Ningdu 342800,China)

机构地区：[1]赣州市宁都县人民医院,江西宁都342800

出　　处：《吉林医学》2023年第4期891-894,共4页Jilin Medical Journal

基　　金：赣州市卫生和计划生育委员会科研计划项目[项目编号:2022-2-207]。

摘　　要：目的:分析彩超引导下双侧腹横肌平面阻滞(TAPB)复合双侧腹直肌鞘阻滞(RSB)在消化道穿孔患者术中的应用效果。方法:选择2020~2021年在宁都县人民医院接受消化道穿孔并行手术治疗患者50例,采用电脑随机法分为对照组和试验组各25例。对照组实施常规全身麻醉,试验组则在对照组的基础上实施彩超引导下TAPB复合RSB进行治疗,观察对术中镇痛药物用量及术后镇痛效果和早期康复指标的影响。结果:试验组手术中出血量、手术持续时间、术中镇痛药物用量、术后24 h镇痛泵按压次数、术后视觉模拟评分以及术后不良反应发生率等均明显少于对照组,术后康复情况优于对照组,差异均有统计学意义(P<0.05)。结论:在消化道穿孔手术中,与常规麻醉相比,实施彩超引导下TAPB复合RSB更能获得理想镇痛效果,有利于降低术后出血量和术后不良反应发生率,促进患者康复,应用效果显著,值得临床推广。Objective To analyze the efficacy of bilateral transverse abdominal muscle block(TAPB)combined with bilateral rectus sheath block(RSB)guided by color ultrasound in patients with digestive tract perforation.Method From 2020 to 2021,50 patients with digestive tract perforation in our hospital were selected and randomly divided into control group and experimental group,with 25 cases in each group.The control group was given conventional general anesthesia,and the experimental group was given TAPB combined with RSB on the basis of the control group.To observe the effects on the amount of intraoperative analgesic drugs,postoperative analgesic effect and early recovery indicators.Results The experimental group was significantly less than the control group in the amount of intraoperative blood loss,duration of operation,amount of intraoperative analgesic drugs,24 h postoperative analgesic pump pressing times,postoperative visual analog score and incidence of postoperative adverse reactions,etc.,and the postoperative recovery was better than the control group(P<0.05).Conclusion Compared with conventional anesthesia,TAPB combined with RSB guided by color ultrasound can achieve more ideal analgesic effect in digestive tract perforation surgery,which is beneficial to reduce postoperative bleeding and the incidence of postoperative adverse reactions,and promote the recovery of patients.The application of TAPB combined with RSB has significant efficacy and is worthy of clinical promotion.

关 键 词：彩超引导 双侧腹直肌鞘阻滞 双侧腹横肌平面阻滞 术中镇痛 消化道穿孔 

分 类 号：R614[医药卫生—麻醉学]