超声引导下腹横肌平面阻滞联合全身麻醉在腹腔镜胆囊切除术患者中的应用效果  

Application effects of ultrasound-guided transversus abdominis plane block combined with general anesthesia in laparoscopic cholecystectomy

作　　者：陈夏雨 CHEN Xiayu(Department of Anesthesiology of Shangqiu Hospital of Traditional Chinese Medicine,Shangqiu 476000 Henan,China)

机构地区：[1]商丘市中医院麻醉科,河南商丘476000

出　　处：《中国民康医学》2025年第7期89-91,95,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察超声引导下腹横肌平面阻滞(TAPB)联合全身麻醉在腹腔镜胆囊切除术患者中的应用效果。方法:回顾性分析2021年7月至2023年11月于该院行腹腔镜胆囊切除术的70例患者的临床资料,按照麻醉方法不同将其分为对照组与研究组各35例。对照组进行全身麻醉,研究组在对照组基础上联合TAPB。比较两组不同时间[麻醉前(T_(0))、气管插管时(T_(1))、建立气腹时(T_(2))、术毕时(T_(3))]血流动力学指标(平均动脉压、心率)水平,手术相关指标[自主呼吸恢复时间、气管拔管时间、苏醒时间和苏醒即刻镇静-躁动(SAS)评分]水平,术后不同时间(术后12、24 h)疼痛[疼痛数字评分法(NRS)]评分,以及不良反应发生率。结果:T_(1)、T_(2)、T_(3)时,两组平均动脉压、心率水平均低于T_(0)时,但研究组高于对照组,差异有统计学意义(P<0.05);研究组自主呼吸恢复时间、气管拔管时间、苏醒时间短于对照组,苏醒即刻SAS评分低于对照组,差异均有统计学意义(P<0.05);术后12、24 h,研究组NRS评分均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下TAPB联合全身麻醉应用于腹腔镜胆囊切除术患者可稳定血流动力学指标水平,改善手术相关指标水平,降低术后疼痛评分,效果优于单纯全身麻醉。Objective:To observe application effects of ultrasound-guided transversus abdominis plane block(TAPB)combined with general anesthesia in patients undergoing laparoscopic cholecystectomy.Methods:The clinical data of 70 patients who underwent laparoscopic cholecystectomy in this hospital from July 2021 to November 2023 were retrospectively analyzed.According to different anesthesia methods,they were divided into control group and study group,35 cases in each group.The control group was given general anesthesia,while the study group was combined with TAPB on the basis of that of the control group.The levels of hemodynamic indexes(mean arterial pressure,heart rate)at different time[before anesthesia(T_(0)),tracheal intubation(T_(1)),establishment of pneumoperitoneum(T_(2)),end of operation(T_(3))],the levels of operationrelated indexes[spontaneous breathing recovery time,tracheal extubation time,recovery time and immediate sedation-agitation sale(SAS)score],the pain[numerical rating scale(NRS)]scores at different time after the surgery(12 h,24 h after the surgery),and the incidence of adverse reactions were compared between the two groups.Results:At T_(1),T_(2) and T_(3),the levels of mean arterial pressure and heart rate of the two groups were lower than those at T_(0),but those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The spontaneous breathing recovery time,the tracheal extubation time and the recovery time of the study group were shorter than those of the control group,the SAS score at the time of recovery was lower than that of the control group,and the differences were statistically significant(P<0.05).12 and 24 h after the surgery,the NRS scores of the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Ultrasound-guided TAPB combined with general

关 键 词：超声引导下腹横肌平面阻滞 全身麻醉 腹腔镜胆囊切除术 血流动力学 疼痛 不良反应 

分 类 号：R614[医药卫生—麻醉学]