CT引导下经胸穿刺活检术中胸膜局部麻醉控制疼痛的有效性和安全性研究  

Efficacy and Safety of Local Pleural Anesthesia in Pain Control during CTguided Transthoracic Biopsy

作　　者：余良鑫 陈伟强[1] 郭春明[1] 丁勇 YU Liang-xin;CHEN Wei-qiang;GUO Chun-ming;DING Yong(Department of Anesthesiology,Shantou Central Hospital,Shantou 515000,Guangdong Province,China;Department of Anesthesiology,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510699,Guangdong Province,China)

机构地区：[1]汕头市中心医院麻醉科,广东汕头515000 [2]广东药科大学附属第一医院麻醉科,广东广州510699

出　　处：《中国CT和MRI杂志》2025年第1期97-99,共3页Chinese Journal of CT and MRI

基　　金：汕头市科技计划医疗卫生项目(191221235263391);2022年度广东省医学科研基金指令性课题项目(C2022099)。

摘　　要：目的 CT引导下经胸穿刺活检术(TNB)中胸膜局部麻醉控制疼痛的有效性和安全性研究。方法 回顾性分析本院于2023年1月至2023年12月在CT引导下接受(A)胸膜和皮肤麻醉(胸膜麻醉组)或(B)单纯皮肤麻醉(皮肤麻醉组)的行TN B患者。疼痛评分在0-5的数字等级范围内报告,疼痛评分3-5被归类为显著疼痛。使用多变量线性回归模型和Logistic回归模型评估胸膜麻醉与疼痛评分、显著疼痛和气胸的关系。结果 111例患者胸麻组疼痛评分(1.40±1.0 vs.2.3±1.1,P<0.001)低于皮麻组(18.4%[7/38]vs.42.5%[31/73],P=0.020)。疼痛评分与胸膜麻醉呈负相关(P<0.001),与手术时间呈正相关(P<0.001)。显著疼痛与胸膜麻醉呈负相关(P=0.004),与手术时间呈正相关(P<0.001)。胸膜麻醉与气胸或胸管置入无关(P=0.806和0.291)。结论胸膜麻醉在不增加气胸风险的前提下,减轻了患者的主观疼痛。Objective To study the efficacy and safety of local pleural anesthesia in pain control during CT-guided tra nsthoracic biopsy(TNB).Methods Patients undergoing TNB who received(A)pleu ral and cutaneous anesthesia(pleural anesthesia group)or(B)cutaneous anesthesia alone(cutaneous anesthesia group)under CT guidance from January 2023 to December 2023 were retrospectively analyzed.Pain scores are reported on a numerical scale of 0-5,with a pain score of 3-5 classified as significant pain.Multivariate linear regression models and Logistic regression models were used to evaluate the relationship between pleural anesthesia and pain scores,significant pain,and pneumothorax.Results The pain sco res of 111 patients in the thora cic anest h esia group(1.40±1.0 vs.2.3±1.1,P<0.001)were lower than those in the skin anesthesia group(18.4%[7/38]vs.42.5%[31/73],P=0.020).Pain scores were negatively correlated with pleural anesthesia(P<0.001)and positively correlated with operative time(P<0.001).Significant pain was negatively correlated with pleural anesthesia(P=0.004)and positively correlated with operative time(P<0.001).Pleural anesthesia was not associated with pneumothorax or chest tube placement(P=0.806 and 0.291).Conclusion Pleural anesthesia can reduce su bjective pain without increasing the risk of pneumothorax.

关 键 词：CT 经胸穿刺活检术 胸膜局部麻醉 控制疼痛 

分 类 号：R655.2[医药卫生—外科学]