腹横肌平面阻滞与切口局部浸润麻醉对单孔腹腔镜胆囊切除术患者切口疼痛及炎症应激反应的影响  

Effects of Transversus Abdominis Plane Block and Incision Local Infiltration Anesthesia on Incision Pain and Inflammatory Stress Response in Patients Undergoing Single Incision Laparoscopic Cholecystectomy

作　　者：梅锋 干雯 徐伟宏 余汉辉 龙响良 MEI Feng;GAN Wen;XU Weihong;YU Hanhui;LONG Xiangliang(Department of General Surgery,Zhongshan Dongfeng People's Hospital,Zhongshan 528425,China;不详)

机构地区：[1]中山市东凤人民医院普外科,广东中山528425

出　　处：《中国医学创新》2025年第6期21-24,共4页Medical Innovation of China

基　　金：中山市第一批社会公益与基础研究项目(2022B1155)。

摘　　要：目的:探讨腹横肌平面阻滞(TAPB)与切口局部浸润麻醉(LIA)对单孔腹腔镜胆囊切除术(SILC)患者切口疼痛及炎症应激反应的影响。方法:选择2022年6月—2024年6月中山市东凤人民医院普外科收治的94例接受SILC的患者,并随机分为两组,每组47例。两组均接受SILC,观察组进行TAPB,对照组进行切口LIA。比较两组数字分级评分法(NRS)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平及住院时间。结果:观察组术后30 min、2 h、6 h NRS评分均显著低于对照组,差异均有统计学意义(P<0.05)。术后1周,观察组TNF-α、IL-6、IL-8水平均低于对照组,差异均有统计学意义(P<0.05)。观察组住院时间短于对照组(P<0.05)。结论:TAPB应用于SILC患者,不仅可显著减轻患者疼痛程度,还可减轻炎症应激反应,促进患者快速康复。Objective:To investigate the effects of transversus abdominis plane block(TAPB)and incision local infiltration anesthesia(LIA)on incision pain and inflammatory stress response in patients undergoing single incision laparoscopic cholecystectomy(SILC).Method:A total of 94 patients received SILC admitted to Department of General Surgery,Zhongshan Dongfeng People's Hospital from June 2022 to June 2024 were selected and randomly divided into two groups,with 47 cases in each group.Both groups received SILC,the observation group received TAPB,and the control group received incision LIA.The numerical rating scale(NRS),the levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)]and hospital stay were compared between the two groups.Result:NRS scores 30 min,2 h and 6 h after operation in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).1 weeks after operation,the levels of TNF-α,IL-6 and IL-8 in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The hospital stay in the observation group was shorter than that in the control group(P<0.05).Conclusion:The application of TAPB in patients undergoing SILC can not only significantly reduce the degree of pain,but also alleviate inflammatory stress response and promote rapid recovery of patients.

关 键 词：腹横肌平面阻滞 切口局部浸润麻醉 单孔腹腔镜胆囊切除术 疼痛 炎症应激反应 

分 类 号：R614[医药卫生—麻醉学]