超声引导腹横肌平面阻滞联合全麻对成人腹腔镜阑尾切除术患者苏醒质量的影响  

Effect of Ultrasound Guided Transverse Abdominis Plane Block Combined with General Anesthesia on the Recovery Quality of Adult Patients Undergoing Laparoscopic Appendectomy

作　　者：宋琼远 刘红艳 王延丽 高青 SONG Qiongyuan;LIU Hongyan;WANG Yanli;GAO Qing(Department of Anesthesiology,Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan,Shan-dong,271199,China)

机构地区：[1]济南市中西医结合医院麻醉科,山东济南271199

出　　处：《中外医疗》2025年第5期5-8,共4页China & Foreign Medical Treatment

摘　　要：目的分析超声引导腹横肌平面阻滞(transversus abdominis plane block,TAPB)联合全麻在成人腹腔镜阑尾切除术(laparoscopic appendectomy,LA)中的应用效果。方法便利选取2021年5月—2023年5月济南市中西医结合医院收治的94例成人LA患者为研究对象,按不同麻醉方法分为两组,各47例。对照组行全麻,观察组加以超声引导TAPB。对比两组血流动力学、苏醒质量、不良反应。结果麻醉时,与对照组相比,观察组的心率、平均动脉压均更低;术毕时,观察组心率、平均动脉压更高,差异均有统计学意义(P均<0.05)。观察组的自主呼吸时间为(9.84±1.59)min、呼之睁眼时间为(11.50±2.35)min、拔管时间为(14.31±3.01)min、完全苏醒时间为(19.25±3.52)min,短于对照组的(11.45±2.36)min、(13.47±2.77)min、(17.95±3.46)min、(24.59±4.38)min,差异均有统计学意义(t=3.879,3.718,5.441,6.515;P均<0.05)。在不良反应的发生率方面,观察组显著低于对照组,差异有统计学意义(P<0.05)。结论在成人LA患者的手术中,超声引导的TAPB联合全麻能够使术中血流动力学保持稳定,加快患者的苏醒速度,并且不良反应的发生率相对较低。Objective To analyze the application effect of ultrasound guided transversus abdominis plane block(TAPB)combined with general anesthesia in adult patients undergoing laparoscopic appendectomy(LA).Methods A total of 94 adult LA patients admitted to Jinan Hospital of Integrated Traditional Chinese and Western Medicine from May 2021 to May 2023 were conveniently selected as the research objects and divided into two groups according to different anesthesia methods,with 47 cases in each group.The control group received general anesthesia,and the observation group received ultrasound guided TAPB.The hemodynamics,recovery quality and adverse reactions were compared between the two groups.Results During anesthesia,compared with the control group,the heart rate and mean arterial pressure of the observation group were lower;at the end of the operation,the heart rate and mean arterial pressure of the observation group were higher,and the differences were statistically significant(all P<0.05).The spontaneous breathing time of the observation group was(9.84±1.59)min,the eye opening time was(11.50±2.35)min,the extubation time was(14.31±3.01)min,and the complete recovery time was(19.25±3.52)min,which was shorter than that of the control group(11.45±2.36)min,(13.47±2.77)min,(17.95±3.46)min,(24.59±4.38)min,the differences were statistically significant(t=3.879,3.718,5.441,6.515;all P<0.05).In terms of the incidence of adverse reactions,the observation group was significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion In the operation of adult LA patients,ultrasound-guided TAPB combined with general anesthesia can effectively stabilize intraoperative hemodynamics,promote faster recovery of patients,and the incidence of adverse reactions is relatively low.

关 键 词：腹腔镜阑尾切除术 超声引导腹横肌平面阻滞 全麻 不良反应 

分 类 号：R614[医药卫生—麻醉学]