腹横肌阻滞在妇科腹腔镜全子宫切除术快速康复中的应用及对患者血清补体C_(3)、C_(4)水平的影响  

Application of transverse abdominal muscle block in rapid rehabilitation of gynecological laparoscopic hysterectomy and its effect on serum complement C_(3) and C_(4) levels of patients

作　　者：何竞月 HE Jing-yue(Department of Gynecology,the First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院妇科,河南南阳473000

出　　处：《医药论坛杂志》2023年第3期23-26,共4页Journal of Medical Forum

摘　　要：目的探讨腹横肌阻滞在妇科腹腔镜全子宫切除术快速康复中应用效果及对患者血清补体C_(3)、C_(4)水平的影响。方法选取2018年11月—2021年2月南阳医学高等专科学校第一附属医院收治的行腹腔镜全子宫切除术患者93例为研究对象,采用数字表法分为对照组(47例)和观察组(46例),观察组采用腹横肌阻滞,对照组仅使用静脉镇痛泵。记录患者手术时间、术中出血量、舒芬太尼使用量和镇痛泵使用次数,于手术前后分别检测患者血清IgG、IgA、IgM、补体C_(3)、C_(4)、C-反应蛋白(CRP)、D-二聚体(D-D)和白介素-6(IL-6)水平,采用视觉模拟评分法(VAS)对患者术后1、2、4、8、12 h疼痛情况进行评估,并记录术后并发症发生情况。结果观察组舒芬太尼使用量(118.29±6.23)、PCA次数(23.09±3.27)均小于对照组的(157.46±7.41)、(42.94±6.73)(t=27.563、18.028,P<0.05);术后,观察组血清IgG、IgA、IgM、补体C_(3)、C_(4)水平均低于对照组(t=10.306、6.008、7.074、2.666、11.323,P<0.05);观察组CRP、D-D、IL-6水平低于对照组(t=3.828、23.163、6.519,P<0.05);观察组术后1 h、2 h、4 h、8 h、12 h疼痛评分均低于对照组(t=6.566、6.823、7.685、7.803、6.684,P<0.05);两组患者手术时间、术中出血量和并发症发生率比较差异无统计学意义(t/χ^(2)=0.425、0.098、0.101,P>0.05)。结论腹横肌阻滞可改善行腹腔镜全子宫切除术患者血清补体C_(3)、C_(4)水平,缓解术后疼痛程度,有利于患者术后快速康复。Objective To investigate the effect of transversus abdominis block in the rapid rehabilitation of gynecological laparoscopic hysterectomy.Methods Ninety-three patients who underwent laparoscopic hysterectomy in our hospital from November 2018 to February 2021 were selected as the research objects.They were divided into the control group(47 cases)and the observation group(46 cases)using a random number table method.The observation group used transversus abdominis block,and the control group only used intravenous analgesia pump.Record the patient’s operation time,intraoperative blood loss,sufentanil usage and the number of analgesic pump usage,and test the patient’s serum IgG,IgA,IgM,complement C_(3),C_(4),C-reactive protein(CRP),and D before and after the operation.-Dimer(DD)and interleukin-6(IL-6)levels,visual analogue scoring(VAS)was used to evaluate and record the patient’s pain at 1 h,2 h,4 h,8 h and 12 h after surgery Postoperative complications occurred.Results The dosage of sufentanil(118.29±6.23)and the number of PCA(23.09±3.27)in the observation group were lower than those in the control group(157.46±7.41)and(42.94±6.73)(t=27.563,18.028,P<0.05).After operation,the serum levels of IgG,IgA,IgM,complement C_(3)and C_(4)in the observation group were lower than those in the control group(t=10.306,6.008,7.074,2.666,11.323,P<0.05).The levels of CRP,D-D and IL-6 in the observation group were lower than those in the control group(t=3.828,23.163,6.519,P<0.05).The pain scores of the observation group at 1 h,2 h,4 h,8 h,and 12 h after operation were lower than those of the control group(t=6.566,6.823,7.685,7.803,6.684,P<0.05).There was no significant difference in operation time,intraoperative blood loss and complication rate between the two groups(t/χ^(2)=0.425,0.098,0.101,P>0.05).Conclusion Transverse abdominal muscle block can improve serum complement C_(3)and C_(4)levels in patients undergoing laparoscopic hysterectomy,relieve postoperative pain,and facilitate rapid postoperative recovery.

关 键 词：腹腔镜全子宫切除术 腹横肌阻滞 快速康复 补体水平 

分 类 号：R614.3[医药卫生—麻醉学]