超声引导下双侧TAP阻滞联合丙泊酚全麻在子宫内膜癌根治术中的应用  

Application of Ultrasound-guided Bilateral TAP Block Combined with Propofol General Anesthesia in Endometrial Cancer Radical Surgery

作　　者：王卫民 李印玉 于海舟 WANG Weimin;LI Yinyu;YU Haizhou(Zhoukou Central Hospital,Zhoukou,466000)

机构地区：[1]河南省周口市中心医院,466000

出　　处：《实用癌症杂志》2025年第2期329-332,336,共5页The Practical Journal of Cancer

摘　　要：目的 探讨在子宫内膜癌根治术中应用丙泊酚全麻联合超声引导下双侧腹横肌平面(TAP)阻滞的效果。方法 该研究为前瞻性随机对照研究,纳入2021年4月至2023年4月医院拟行子宫内膜癌根治术治疗的58例患者为研究对象,以随机数字表法分为对照组(29例,丙泊酚全麻)和观察组(29例,丙泊酚全麻+超声引导下双侧TAP阻滞)。比较2组患者麻醉相关指标、疼痛程度[视觉模拟评分法(VAS)评分]、认知功能[简明精神状态检查表(MMSE)评分]以及麻醉前和拔管后纤溶功能指标[D-二聚体(D-D)、组织纤溶酶原激活物抑制剂-1(PAI-1)、组织型纤溶酶原激活物(t-PA)],统计2组术后不良反应发生情况。结果 对照组丙泊酚使用剂量多于观察组(P<0.05);对照组术后6 h、12 h、24 h时VAS评分显著高于观察组(P<0.05);对照组术后6 h、24 h、48 h时MMSE评分显著低于观察组(P<0.05);对照组拔管后血清PAI-1、D-D、t-PA水平高于观察组(P<0.05)。对照组术后不良反应总发生率高于观察组(P<0.05)。结论 丙泊酚全麻联合超声引导下双侧TAP阻滞可减少对子宫内膜癌根治术患者认知功能、纤溶功能的影响,降低术后疼痛程度和不良反应发生情况,且不会影响患者苏醒质量。Objective To explore the application effect of propofol general anesthesia combined with ultrasound-guided bilateral transverse abdominis plane(TAP)block in radical surgery for endometrial cancer.Methods This study was a prospective randomized controlled trial,involving 58 patients who underwent radical surgery for endometrial cancer as the study subjects.They were randomly divided into the control group(29 cases,propofol general anesthesia)and the observation group(29 cases,propofol general anesthesia+ultrasound-guided bilateral TAP block)using a random number table method.Anesthesia related indicators,pain level[Visual Analog Scale(VAS)score],cognitive function[Mini Mental State Examination(MMSE)score],as well as fibrinolytic function indicators[D-dimer(D-D),tissue plasminogen activator inhibitor-1(PAI-1),and tissue plasminogen activator(t-PA)]were compared before and after extubation in two groups of patients,andthe incidence of postoperative adverse reactions in both groups were recorded.Results The dosage of propofol used in the control group was higher than that in the observation group(P<0.05).The VAS score of the control group was significantly higher than that of the observation group at 6h,12h,and 24h after surgery(P<0.05).The MMSE score in the control group was significantly lower than that in the observation group at 6h,24h,and 48h after surgery(P<0.05).The serum levels of PAI-1,D-D,and t-PA in the control group were higher than those in the observation group after extubation(P<0.05).The total incidence of postoperative adverse reactions in the control group was higher than that in the observation group(P<0.05).Conclusion Propofol general anesthesia combined with ultrasound-guided bilateral TAP block can reduce the impact on cognitive function and fibrinolysis function in patients undergoing endometrial cancer radical surgery,reduce postoperative pain and adverse reactions,and do not affect the quality of patient recovery.

关 键 词：超声引导 腹横肌平面阻滞 全身麻醉 子宫内膜癌根治术 

分 类 号：R737.33[医药卫生—肿瘤]