超声引导下胸椎旁神经阻滞联合腕踝针对胸腔镜下肺叶切除患者术后疼痛的效果观察  

Effect of ultrasound-guided thoracic paravertebral nerve block combined with wrist ankle needle on postoperative pain in patients with thoracoscopic lobectomy

作　　者：黄博 黄跃英 HUANG Bo;HUANG Yueying(Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang330006,China;Department of Nursing,South Changjiang Rehabilitation Hospital,Jiangxi Province,Nanchang330013,China)

机构地区：[1]南昌大学第二附属医院肝胆外科,江西南昌330006 [2]南昌江投康复医院护理部,江西南昌330013

出　　处：《中国当代医药》2025年第6期110-114,共5页China Modern Medicine

基　　金：江西省中医药管理局科技计划项目(2022B538)。

摘　　要：目的探讨超声引导下胸椎旁神经阻滞联合腕踝针对胸腔镜下肺叶切除患者术后疼痛的效果。方法选取2023年9月至2024年3月南昌大学第二附属医院收治的140例胸腔镜下肺叶切除患者作为研究对象,按照随机数字表法分为对照组(70例)与观察组(70例)。对照组采用单纯胸椎旁神经阻滞镇痛,试验组采用腕踝针疗法联合胸椎旁神经阻滞镇痛。比较两组的视觉模拟评分法(VAS)评分、术后认知功能障碍、镇痛药物用量、患者满意度情况。结果两组的术后即刻VAS评分比较,差异无统计学意义(P>0.05),观察组术后6 h,1、2 d时VAS评分低于对照组,差异有统计学意义(P<0.05);观察组术后MMSE评分高于对照组,差异有统计学意义(P<0.05);观察组主动镇痛次数、镇痛药物用量少于对照组,差异有统计学意义(P<0.05);观察组患者满意度高于对照组,差异有统计学意义(P<0.05)。结论在胸腔镜下肺叶切除患者术后疼痛中,采用超声引导下胸椎旁神经阻滞联合腕踝针方案,镇痛效果较好,有助于改善认知功能障碍问题,且用药量更少,应用价值更高。Objective To investigate the effect of ultrasound-guided thoracic paravertebral nerve block combined with wrist-ankle needle on postoperative pain in patients with thoracoscopic lobectomy.Methods A total of 140 patients with thoracoscopic lobectomy admitted to the Second Affiliated Hospital of Nanchang University from September 2023 to March 2024 were selected as the study objects,and they were divided into control group(70 cases)and observation group(70 cases)according to random number table method.The control group received thoracic paravertebral nerve block and analgesia alone,and the experimental group received wrist-ankle needle combined with thoracic paravertebral nerve block and analgesia.The visual analogue scale(VAS)score,postoperative cognitive dysfunction,analgesic drug dosage and patient satisfaction were compared between the two groups.Results There were no significant differences in VAS scores between the two groups(P>0.05).VAS scores of the observation group at 6 h,1 and 2 d after surgery were lower than those of the control group,with statistical significances(P<0.05).The MMSE score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The number of active analgesia and the dosage of analgesic drugs in the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).The patient satisfaction in observation group was higher than that in control group,the difference was statistically significant(P<0.05).Conclusion In the postoperative pain of patients with thoracoscopic lobectomy,ultrasound guided thoracic paravertebral nerve block combined with wrist-ankle needle has better analgesic effect,which is helpful to improve cognitive dysfunction,with less drug consumption and higher application value.

关 键 词：超声 胸椎旁神经阻滞 腕踝针 胸腔镜 肺叶切除 镇痛 

分 类 号：R730.41[医药卫生—肿瘤]