超声引导下TFP阻滞与TAP阻滞在剖宫产术后镇痛效果对比  

Comparison of the analgesia effect of the ultrasound-guided transversalis fascia plane block and transversus abdominis plane block for women after cesarean section

作　　者：贺方坤 彭琳杰 HE Fangkun;PENG Linjie(The Second People's Hospital of Jintang County,Chengdu,Sichuan Province,610404)

机构地区：[1]四川省金堂县第二人民医院,610404

出　　处：《中国计划生育学杂志》2025年第1期90-94,共5页Chinese Journal of Family Planning

摘　　要：目的:探究超声引导下腹横筋膜平面阻滞(TFP)与横肌平面阻滞(TAP)在剖宫产术后镇痛效果比较。方法:回顾性分析2022年1月-2023年8月本院妇产科行剖宫产术产妇临床资料,将术后行超声引导TFP阻滞的117例纳入TFP组、接受超声引导TAP阻滞115例纳入TAP组。比较两组术后24h内镇痛效果[镇痛泵按压次数、视觉模拟评分法(VAS)评分],术后恢复情况(术后首次下床时间、术后至出院时间),术前、术后12h和术后24h两组血流动力学指标[心率(HR)、平均动脉压(MAP)]、应激反应指标[皮质醇(COR)、C-肽(C-P)],炎症水平[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]。结果:术后24h内TFP组镇痛泵按压次数(6.85±1.38次)和VAS评分(3.97±0.81分)均低于TAP组(7.23±1.51次、4.28±0.93分),术后首次下床时间(1.18±0.09d)和术后至出院时间(5.78±1.17d)均低于TAP组(1.24±0.12d、6.31±1.21d);术后12h、24h,两组血流动力学指标和应激反应指标均较术前提高,但TFP组低于TAP组,TFP组炎症水平低于TAP组(均P<0.05)。结论:相比于TAP阻滞,超声引导下的TFP阻滞用于剖宫产术后镇痛效果更显著,TFP阻滞还能调节机体血流动力学状态,减轻应激反应和炎症反应。Objective:To compare the analgesia effect of the ultrasound-guided transversalis fascia plane(TFP)block and transversus abdominis plane(TAP)block for women after cesarean section.Methods:The clinical data of the women who had received cesarean section in the hospital from January 2022 to August 2023 were analyzed retrospectively.117 women who had adopted the ultrasound-guided TFP block after surgery were included in group A,and 115 puerperae who had received the ultrasound-guided TAP block after surgery were enrolled in group B.The analgesic effect evaluated by the analgesic pump compression frequency and the visual analogue scale(VAS)score within 24h after surgery,the postoperative recovery status evaluated by the time of the first postoperative getting out of bed and the time from the end of surgery to discharge,the values of hemodynamic indicators,such as the heart rate(HR)and mean arterial pressure(MAP),the levels of stress response indicators,such as the cortisol(COR)and C-peptide(CP),and the levels of inflammatory indicators,such as the C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),before surgery and at 12h and 24h after surgery of the women were compared between the two groups.Results:The number of the pressing analgesia pump(6.851.38 times)and the VAS score(3.97±0.81 points)of the women in group A within 24h after surgery were significantly lower than those(7.23±1.51 times and 4.28±0.93 points)of the women in group B.The first time to getting out of bed(1.18±0.09 d)and the time from surgery to discharge(5.78±1.17 d)of the women in group A were significantly lower than those(1.24±0.12 d and 6.31±1.21 d)of the women in group B.The values of the hemodynamic indexes and the stress response indexes of the women in the two groups at 12h and 24h after surgery had increased significantly,and which of the women in group A were significantly lower than those of the women in group B,The inflammation level of the women in group A was significantly lower than that of the women

关 键 词：剖宫产 术后镇痛 超声引导 TFP阻滞 TAP阻滞 镇痛效果 应激反应 炎症因子 

分 类 号：R614[医药卫生—麻醉学]