超声引导下腹横肌平面阻滞对腹膜透析置管术的镇痛效果观察  

Analgesic Effect of Ultrasound-guided Transversus Abdominis Plane Block on Peritoneal Dialysis Cannulation

作　　者：李鎛江 董建华[1] 潘红霞[1] 胡祥[1] LI Bo-jiang;DONG Jian-hua;PAN Hong-xia(Department of Nephrology,Leshan People’s Hospital,Leshan,Sichuan,614000,China)

机构地区：[1]乐山市人民医院肾病内科,四川乐山614000

出　　处：《黑龙江医学》2023年第7期777-779,共3页Heilongjiang Medical Journal

基　　金：四川省乐山市重点科技计划项目(19SZD206)。

摘　　要：目的:探讨超声引导下腹横肌平面阻滞对腹膜透析置管术的镇痛效果。方法:选取2018年11月—2020年12月乐山市人民医院肾病内科行腹膜透析置管术的30例终末期肾病患者作为研究对象。采用随机数表法将患者分为观察组和对照组,每组各15例。观察组采用超声引导下腹横肌平面阻滞,对照组采用局部浸润麻醉。比较两组患者术中及术后视觉模拟评分、不良反应发生情况。结果:观察组在术中切皮时、分离皮下组织时、分离腹直肌时、缝皮时,以及术后2 h、术后6 h、术后12 h、术后24 h的视觉模拟评分均显著低于对照组,差异有统计学意义(P<0.05);观察组和对照组患者的麻醉不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下腹横肌平面阻滞安全有效,可作为终末期肾病患者腹膜透析置管术的主要麻醉选择。Objective:To investigate the analgesic effect of ultrasound-guided transversus abdominis plane block in peritoneal dialysis catheter implantation.Methods:30 patients with end-stage renal disease who underwent peritoneal dialysis placement in the hospital from November 2018 to December 2020 were selected as study subjects,and the patients were divided into observation and control groups using the random number table method,with 15 cases in each group.Ultrasound-guided transversus abdominis plane block was used in the observation group,and local infiltration anesthesia was used in the control group.Intraoperative and postoperative visual simulation scores and the occurrence of adverse events were compared between the two groups of patients.Results:The visual simulation scores of the observation group were significantly lower than those of the control group during intraoperative skin incision,separation of subcutaneous tissue,separation of the rectus abdominis muscle,and suturing of the skin,as well as at 2 h,6 h,12 h,and 24 h postoperatively,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of adverse anesthesia reactions between patients in the observation and control groups(P>0.05).Conclusion:Ultrasound-guided transversus abdominis plane block is safe and effective and can be the primary anesthetic option for peritoneal dialysis placement in patients with end-stage renal disease.

关 键 词：腹膜透析置管术 超声引导 腹横肌平面阻滞 局部浸润麻醉 

分 类 号：R58[医药卫生—内分泌]