| 程珊珊,王 涛,孙建宏,梁小女,张建友.超声引导下腰丛神经阻滞在老年患者腹股沟斜疝手术中的应用[J].,2019,19(4):710-713 |
| 超声引导下腰丛神经阻滞在老年患者腹股沟斜疝手术中的应用 |
| Application of Ultrasound guided Lumbar Plexus Nerve Block in Indirect Inguinal Hernia Surgery in Eldly Patients |
| 投稿时间：2018-05-29 修订日期：2018-06-25 |
| DOI：10.13241/j.cnki.pmb.2019.04.023 |
| 中文关键词: 超声引导 腰丛阻滞 腹股沟斜疝 |
| 英文关键词: Ultrasound guided Lumbar plexus nerve block Indirect inguinal hernia surgery |
| 基金项目:江苏省青年医学人才项目（QNRC2016354）；扬州市科技发展项目（2018085） |
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| 中文摘要: |
| 摘要 目的：探讨超声引导下腰丛神经阻滞应用于老年患者腹股沟斜疝手术中的血流动力学变化及麻醉效果。方法：选取腹股沟斜疝手术患者39 例，随机分为观察组(19 例,U组)及对照组(20 例，C组)。观察组患者采用超声引导下腰丛神经阻滞麻醉，对照组患者采用腰硬联合阻滞麻醉。记录两组患者麻醉开始前(T0)、注药后5 min(T1)、10 min (T2)、20 min(T3)、60 min(T4)及术毕(T5)的平均动脉血压(MAP)、心率(HR)、脉搏血氧饱和度(SPO2)；评价两组患者的麻醉效果；记录麻醉后4、8、12、24、48 h的VAS评分；记录术后发生恶心呕吐，头痛、尿储留的例数。结果：C组T1、T2、T3时间点的心率高于U组，差异具有统计学意义（P<0.05）；C组T1、T2、T3时间点的MAP低于U组，差异具有统计学意义（P<0.05）；两组麻醉优良率均为100 %；C组麻醉后8 h、12 h的VAS评分高于U组，差异具有统计学意义（P<0.05）；C组术中升压药使用率高于U组，差异具有统计学意义（P<0.05）；结论：超声引导下腰丛神经阻滞麻醉应用于腹股沟疝手术效果确切，血流动力学稳定，并发症较少。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the hemodynamic changes and anesthetic effects of the application of ultrasound guided lum- bar plexus nerve block in indirect inguinal hernia surgery in eldly patients. Methods: 39 patients with indirect inguinal hernia surgery were randomly divided into observation group（19 cases, Group U） and control group（20 cases, Group C）. The observation group was treated with ultrasound guided lumbar plexus block anesthesia, while the control group was treated with combined spinal-epidural anes- thesia. Mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SPO2)were compared at the time pre-anethesia (T0), the time after anesthesia [5 mins(T1), 10 mins (T2), 20 mins (T3), 60 mins (T4)] and the time post-operation (T5); to compare the anes- thetic effects between two groups; the VAS scores were recorded at 4, 8, 12, 24, 48 hours after anesthesia; to record the cases of postop- erative nausea, vomiting, headache and urinary retention. Results: In Group C, the HR at T1, T2, T3 were higher than those in Group U, the difference was statistically significant (P<0.05); in Group C, the MAP at T1, T2, T3 were lower than those in Group U, the difference was statistically significant（P<0.05）; the anesthesia excellent rate of two groups were both 100%; at 8 h and 12 h after anesthesia, the VAS scores of Group C were both higher than those of Group U, the difference was statistically significant（P<0.05）; in Group C, the use of vasopressors was higher than that in Group U, the difference was statistically significant(P<0.05); in Group C, postoperative nausea and vomiting and urinary retention rate was higher than that of Group U(P<0.05). Conclusion: Ultrasound guided lumbar plexus block anesthesia used in inguinal hernia surgery has reliable effect, stable hemodynamics and fewer complications. |
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