超声下单点胸椎旁阻滞在经皮肾镜碎石术中的应用研究  

Application research of ultrasound single point thoracic paravertebral block in percutaneous nephrolithotomy

作　　者：陆庆鹏 肖艳霞 赖少锋 李文辉 LU Qingpeng;XIAO Yanxia;LAI Shaofeng;LI Wenhui(Department of Anesthesiology,Dongguan Fenggang Hospital,Guangdong Province,Dongguan 523681,China)

机构地区：[1]广东省东莞市凤岗医院麻醉科,广东东莞523681

出　　处：《中国当代医药》2025年第3期85-88,92,共5页China Modern Medicine

基　　金：广东省东莞市社会发展科技项目(20221800902932)。

摘　　要：目的探讨超声下单点胸椎旁阻滞在经皮肾镜碎石术的应用效果。方法选取2022年1月至2024年4月在东莞市凤岗医院接受经皮肾镜碎石术的40例患者作为研究对象,按照随机数字表法分为观察组和对照组,每组20例。观察组采用超声引导下的单点胸椎旁阻滞术,而对照组则采用椎管内麻醉,比较两组患者的手术指标、不同时间点的视觉模拟评分法(VAS)评分、生命体征以及术后不良反应。结果观察组T_(1)时刻的平均动脉压(MAP)、心率(HR)高于对照组,T_(2)、T_(3)时刻的MAP、HR低于对照组,差异有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3)、T_(4)时,两组患者的MAP均低于本组T_(0)时,观察组的HR均低于本组T_(0)时,差异有统计学意义(P<0.05);对照组T_(1)时刻的HR低于本组T_(0)时,T_(2)、T_(3)、T_(4)时刻的HR高于本组T_(0)时,差异有统计学意义(P<0.05)。观察组T_(1)、T_(2)、T_(3)及T_(4)时刻的血氧饱和度(SpO_(2))高于对照组,差异有统计学意义(P<0.05)。T_(1)、T_(2)、T_(3)及T_(4)时,观察组的SpO_(2)均高于本组T_(0)时,对照组的SpO_(2)均低于本组T_(0)时,差异有统计学意义(P<0.05)。观察组的手术时间、术后排气时间、住院时间短于对照组,术中出血量低于对照组,差异有统计学意义(P<0.05)。术后2、6 h,观察组的VAS评分低于对照组,差异有统计学意义(P<0.05)。术后12、24 h,两组患者的VAS评分比较,差异无统计学意义(P>0.05)。观察组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论超声下单点胸椎旁阻滞在经皮肾镜碎石术中效果显著,术中患者呼吸、循环影响小,生命体征更平稳,促进术后恢复和缩短住院时间,并有效控制术后疼痛,是一种安全有效的麻醉方法。Objective To investigate the application effect of ultrasound single point thoracic paravertebral block in percutaneous nephrolithotomy.Methods A total of 40 patients who received percutaneous nephrolithotomy in Dongguan Fenggang Hospital from January 2022 to April 2024 were selected as the research objects,and they were divided into observation group and control group according to random number table method,with 20 patients in each group.The observation group was treated with single point thoracic paravertebral block guided by ultrasound,while the control group was treated with intravertebral anesthesia.The surgical indexes,visual analogue scale(VAS)scores at different time points,vital signs and postoperative adverse reactions of the two groups were compared.Results The mean arterial pressure(MAP)and heart rate(HR)of the observation group at T_(1)were higher than those of the control group,and the MAP and HR at T_(2)and T_(3)were lower than those of the control group,with statistical significances(P<0.05).At T_(1),T_(2),T_(3)and T_(4),MAP in two groups were lower than those at T_(0),and HR in observation group was lower than that at T_(0),the differences were statistically significant(P<0.05).The HR at T_(1)of the control group was lower than that at T_(0),the HR of the control group at T_(2),T_(3)and T_(4)were higher than those at T_(0),the differences were statistically significant(P<0.05).The blood oxygen saturation(SpO_(2))at T_(1),T_(2),T_(3)and T_(4)of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).At T_(1),T_(2),T_(3)and T_(4),SpO_(2)in the observation group were higher than those of T_(0),and SpO_(2)in the control group were lower than those of T_(0),the differences were statistically significant(P<0.05).The operation time,postoperative exhaust time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was lower than that in the control group,the differences w

关 键 词：超声引导 单点胸椎旁阻滞 经皮肾镜碎石术 麻醉 

分 类 号：R614[医药卫生—麻醉学]