静脉麻醉诱导联合前腰方肌阻滞对腹腔镜肾肿瘤肾部分切除术患者术后疼痛和血流动力学的影响  

Effect of intravenous anesthesia induction combined with anterior quadriceps block on postoperative pain and hemodynamics in patients undergoing laparoscopic partial nephrectomy for renal tumors

作　　者：马涛 戚娟 张爱荣 李欣鑫 王景阳 涂强 MA Tao;QI Juan;ZHANG Ai-rong(Department of Anesthesiology,Cangzhou People's Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市人民医院麻醉科,河北沧州061000 [2]沧州和平医院医学检验科,河北沧州061000 [3]河北港口集团有限公司秦皇岛中西医结合医院,河北秦皇岛066005

出　　处：《临床和实验医学杂志》2025年第2期207-210,共4页Journal of Clinical and Experimental Medicine

基　　金：2022年度河北省医学科学研究课题计划(编号:20220643)。

摘　　要：目的观察静脉麻醉诱导联合前腰方肌阻滞对腹腔镜肾肿瘤肾部分切除术患者术后疼痛和血流动力学的影响。方法回顾性选取2021年1月至2024年1月入沧州市人民医院的84例肾肿瘤患者作为研究对象,根据麻醉方式不同分为联合组(静脉麻醉诱导联合前腰方肌阻滞,n=42)与单一组(静脉麻醉诱导,n=42)。比较两组患者不同时间段(术后1 h、6 h、12 h、1 d、2 d)的疼痛视觉模拟评分法(VAS)评分及微循环指标(血液流态、管襻形态积分)水平,不同时间段(进入手术室时、麻醉诱导3 min后、开始手术时、手术完成时、转运出手术室时)的血流动力学指标(平均动脉压、心率)、不同时间段(麻醉诱导前30 min、术后6 h、1 d、3 d)的简易智力状态检查量表(MMSE)评分。结果(1)联合组患者术后1 h、6 h、12 h、1 d、2 d的VAS评分均低于单一组,差异均有统计学意义(P<0.05)。(2)两组患者术后1 h的血液流态、管襻形态积分比较,差异均无统计学意义(P>0.05);联合组患者术后6 h、12 h、1 d、2 d的血液流态、管襻形态积分均低于单一组,差异均有统计学意义(P<0.05)。(3)两组患者进入手术室时、麻醉诱导3 min后、开始手术时、手术完成时、转运出手术室时的心率比较,差异均无统计学意义(P>0.05);两组患者进入手术室时、麻醉诱导3 min后的平均动脉压比较,差异均无统计学意义(P>0.05);联合组患者开始手术时、手术完成时、转运出手术室时的平均动脉压均低于单一组,差异均有统计学意义(P<0.05)。(4)两组患者麻醉诱导前30 min、术后3 d的MMSE评分比较,差异均无统计学意义(P>0.05);联合组患者术后6 h、1 d的MMSE评分均高于单一组,差异均有统计学意义(P<0.05)。结论与单纯静脉麻醉诱导相比,腹腔镜肾肿瘤肾部分切除术中静脉麻醉诱导联合前腰方肌阻滞可明显减轻患者疼痛,增强微循环及血流动力学稳定性,且术后认知功能更�Objective To observe the effect of intravenous anesthesia induction combined with anterior lumbar muscle block on postoperative pain and hemodynamics in patients undergoing partial nephrectomy for laparoscopic renal tumors.Methods A total of 84 patients with renal tumors admitted to Cangzhou People's Hospital from January 2021 to January 2024 were retrospectively selected as the research objects.According to different anesthesia method,they were divided into the combined group(intravenous anesthesia induction combined with anterior lumbar quadratus block,n=42)and the single group(intravenous anesthesia induction,n=42).The pain visual analogue scale(VAS)score and microcirculation index(blood flow state,loop shape integral)levels of the two groups of patients at different time periods(1 h,6 h,12 h,1 d,2 d after operation),the hemodynamic indexes(mean arterial pressure,heart rate)of the two groups of patients at different time periods(entering the operating room,3 min after anesthesia induction,beginning of operation,completion of operation,transfer out of the operating room),and the mini-mental state examination(MMSE)score of the two groups of patients at different time periods(30 min before anesthesia induction,6 h,1 d,3 d after operation)were compared.Results(1)The VAS scores of the combined group at 1 h,6 h,12 h,1 d and 2 d after operation were lower than those of the single group,and the differences were statistically significant(P<0.05).(2)There were no statistically significant differences in the scores of blood flow pattern and vascular loop morphology between the two groups at 1 h after operation(P>0.05).The scores of blood flow pattern and vascular loop morphology in the combined group were lower than those in the single group at 6 h,12 h,1 d and 2 d after operation,and the differences were statistically significant(P<0.05).(3)There were no statistically significant differences in heart rate between the two groups at the time of entering the operating room,3 min after anesthesia induction,beginning of surg

关 键 词：肾肿瘤 腹腔镜 静脉麻醉 疼痛 前腰方肌阻滞 血流动力学 

分 类 号：R47[医药卫生—护理学]