超声引导下腹横肌平面阻滞联合腹直肌鞘阻滞在腹膜透析置管术中的应用  

Application of Ultrasound-guided Transversus Abdominis Plane Block Combined with Rectus Sheath Block in Peritoneal Dialysis Catheterization

作　　者：张军 ZHANG Jun(The Second Hospital of Longyan,Longyan 364000,China)

机构地区：[1]龙岩市第二医院,福建龙岩364000

出　　处：《中外医学研究》2024年第23期127-130,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨超声引导下腹横肌平面阻滞(TAPB)联合腹直肌鞘阻滞(RSB)在腹膜透析置管术(PDC)中的应用效果。方法:选择2021年8月—2023年8月龙岩市第二医院收治的83例PDC患者作为研究对象,根据麻醉方案不同分为TAPB组(n=27)、RSB组(n=28)与联合阻滞组(n=28)。比较三组血流动力学、疼痛程度及术后并发症发生情况。结果:三组麻醉即刻(T_(0))、切皮时(T_(1))、腹直肌分离时(T_(2))、皮下隧道建立时(T_(3))及缝皮时(T_(4))平均动脉压(MAP)、心率比较,差异无统计学意义(P>0.05)。三组T_(1)、T_(2)、T_(3)、T_(4)视觉模拟评分法(VAS)评分比较,差异有统计学意义(P<0.05);且联合阻滞组T_(1)、T_(2)、T_(3)、T_(4) VAS评分低于TAPB组和RSB组,差异有统计学意义(P<0.05)。联合阻滞组术后并发症发生率低于TAPB组和RSB组,差异有统计学意义(P<0.05)。结论:TAPB和RSB联合应用于PDC患者中,有助于维持血流动力学稳定,镇痛效果更好,且能减少术后并发症。Objective:To explore the application effect of ultrasound-guided transversus abdominis plane block(TAPB)combined with rectus sheath block(RSB)in peritoneal dialysis catheterization(PDC).Method:A total of 83 patients with PDC who admitted to the Second Hospital of Longyan from August 2021 to August 2023 were selected as the research objects,they were divided into TAPB group(n=27),RSB group(n=28)and combined block group(n=28)according to different anesthesia schemes.The hemodynamics,pain degree and postoperative complications were compared among three groups.Result:There were no significant differences in the mean arterial pressure(MAP)and heart rate among three groups at the time of anesthesia(T_(0)),skin incision(T_(1)),rectus abdominis separation(T_(2)),subcutaneous tunnel establishment(T_(3))and skin suture(T_(4))(P>0.05).There were significant differences in visual analogue scale(VAS)scores at T_(1),T_(2),T_(3) and T_(4) among three groups(P<0.05);the VAS scores in combined block group at T_(1),T_(2),T_(3) and T_(4) were lower than those in TAPB group and RSB group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in combined block group was lower than those in TAPB group and RSB group,and the differences were statistically significant(P<0.05).Conclusion:The combined application of TAPB and RSB in PDC patients helps to maintain hemodynamic stability,has better analgesic effect,and can reduce postoperative complications.

关 键 词：腹横肌平面阻滞 腹直肌鞘阻滞 腹膜透析置管术 超声引导 

分 类 号：R692.5[医药卫生—泌尿科学]