超声引导下Ⅱ型胸神经阻滞在乳腺良性肿瘤手术中的临床研究  

Clinical research of ultrasound-guided PECS-Ⅱblocks in surgery of patients with benign tumor of breast

作　　者：全燕 刘印华 胡剑梅 刘忠玉 Quan Yan;Liu Yinhua;Hu Jianmei;Liu Zhongyu(Department of Anesthesiology,Maternity and Child Care Center of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市妇幼保健院麻醉科,秦皇岛066000

出　　处：《中国医学装备》2024年第2期89-93,共5页China Medical Equipment

基　　金：河北省卫生和计划生育科研项目(20201262)。

摘　　要：目的:探讨超声引导下Ⅱ型胸神经阻滞(PECS-Ⅱ)麻醉在乳腺良性肿瘤切除术中的应用效果。方法:选取2021年1-12月秦皇岛市妇幼保健院收治的60例行乳腺良性肿瘤切除术的女性患者,按照随机数表法将其分为胸神经阻滞组(神经阻滞组)和局部浸润麻醉组(局部麻醉组),每组30例。神经阻滞组采用超声引导下PECS-Ⅱ麻醉,局部麻醉组采用肿瘤局部浸润麻醉。对比分析两组患者的血流动力学指标、术后视觉模拟量表(VAS)评分、术后镇痛药物的首次干预时间以及术后24 h内舒芬太尼的使用情况。结果:神经阻滞组的平均手术时间为(127.32±34.56)min,与局部麻醉组平均手术时间(128.11±33.84)min相比,差异无统计学意义(P>0.05);两组患者在麻醉开始前(T0)的心率(HR)、平均动脉压(MAP)相比,差异无统计学意义(P>0.05),在切皮时(T1),手术开始0.5 h后(T2),手术结束(T3)时,神经阻滞组HR与MAP水平显著低于局部麻醉组,差异有统计学意义(tHR=5.709、5.836、5.662,tMAP=3.501、3.223、3.128,P<0.05)。与局部麻醉组相比,术后0.5、2、4和6 h神经阻滞组的VAS评分疼痛程度明显降低,差异具有统计学意义(t=4.501、6.575、8.197、8.262,P<0.05);神经阻滞组患者术后首次镇痛药物介入时间明显延后于局部麻醉组,且术后24 h内舒芬太尼消耗量也明显降低,差异具有统计学意义(t=13.741、9.482,P<0.05)。结论:超声引导下的PECS-Ⅱ可有效缓解乳腺良性肿瘤患者的术后早期疼痛,延迟患者术后镇痛药物的干预时间,降低阿片类药物的摄入量。Objective:To explore the application effect of ultrasound-guided pectoralis II(PECS-II)blocks anesthesia in benign tumor resection of breast.Methods:A total of 60 female patients who underwent benign tumor resection of breast were selected from Maternity and Child Care Center of Qinhuangdao from January 2021 to December 2021,and they were divided into the thoracic nerve block group(nerve block group)and local infiltration anesthesia group(local anesthesia group)according to the random number table method.The nerve block group used ultrasound-guided PECS-Ⅱanesthesia,and the local anesthesia group used local infiltration anesthesia for tumor.The hemodynamic indicators,postoperative visual analogue score,first intervention time of postoperative analgesic drugs,and the use of sufentanil within 24 hours after surgery were compared and analyzed between the two groups of patients.Results:The average operation time of the nerve block group was(127.32±34.56)min,and the difference of that between the nerve block group and local anesthesia group(128.11±33.84)min was no statistically significant(P>0.05).The differences of the heart rate(HR)and mean arterial pressure(MAP)before anesthesia(T0)between two groups of patients were not statistically significant(P>0.05).The HR and MAP levels at the time of skin incision(T1),at the 0.5 h after the surgery was conducted(T2)and the time of completing surgery(T3)in nerve block group were significantly lower than those of the local anesthesia group,respectively.The differences were statistically significant(tHR=5.709,5.836,5.662,tMAP=3.501,3.223,3.128,P<0.05),respectively.Compared with the local anesthesia group,the pain level at the same time point in the nerve block group was significantly reduced,and the difference was statistically significant(t=4.501,6.575,8.197,8.262,P<0.05),respectively.The intervention time of analgesic medication at the first time of the nerve block group was significantly later than that of the local anesthesia group,and the consumption of sufentanil withi

关 键 词：Ⅱ型胸神经阻滞(PECS-Ⅱ) 术后疼痛 乳腺良性肿瘤手术 

分 类 号：R445.1[医药卫生—影像医学与核医学]