[1]史 涛,杨永朋.超声引导腰方肌阻滞对腹腔镜结肠癌根治术患者围术期疼痛及预后的影响[J].陕西医学杂志,2022,51(10):1215-1218.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.009]
　SHI Tao,YANG Yongpeng.Effect of ultrasound-guided quadratus lumborum block on perioperative pain and prognosis in patients with laparoscopic radical colonectomy[J].,2022,51(10):1215-1218.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.009]
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超声引导腰方肌阻滞对腹腔镜结肠癌根治术患者围术期疼痛及预后的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年10期
页码:
1215-1218
栏目:
临床研究
出版日期:
2022-10-05

文章信息/Info

Title:
Effect of ultrasound-guided quadratus lumborum block on perioperative pain and prognosis in patients with laparoscopic radical colonectomy
作者:
史 涛1; 杨永朋2
(1.铜川市人民医院手术麻醉科,陕西 铜川 727031; 2.铜川矿务局中心医院手术麻醉科,陕西 铜川 727000)
Author(s):
SHI Tao; YANG Yongpeng
(Department of Surgical Anesthesia,Tongchuan People's Hospital,Tongchuan 727031,China)
关键词:
超声检查;  腰方肌阻滞;  腹腔镜根治术;  结肠癌;  围手术期;  疼痛
Keywords:
Ultrasound;  Quadratus lumborum block;  Laparoscopic radical resection;  Colon cancer;  Perioperative period;  Pain
分类号:
R 735.35
DOI:
DOI:10.3969/j.issn.1000-7377.2022.10.009
文献标志码:
A
摘要:
目的:探究采用腹腔镜结肠癌根治术过程中选用超声引导腰方肌阻滞的镇痛疗效及对患者预后的影响,以便为结肠癌患者手术中的麻醉方式提供理论依据。 方法:将接受腹腔镜根治术的80例结肠癌患者为研究对象,并将其按随机数字表法分为观察组和对照组(各40例)。对照组患者采用全身麻醉,观察组患者在超声引导下的腰方肌阻滞完成后进行静脉全麻。①记录并比较两组患者首次排气时间、首次下床时间、苏醒时间以及拔管时间等情况; ②比较两组患者术前(T0)、术后3 h(T1)以及术后6 h(T2)的疼痛状况; ③记录并比较两组患者镇痛补救次数以及术中、术后镇痛药物消耗情况; ④比较两组患者不良反应发生情况。结果:①观察组患者各项手术指标均明显优于对照组患者,组间比较差异有统计学意义(P<0.05); ②术前两组患者疼痛状况比较无统计学差异(P>0.05),术后3 h、术后6 h两组患者VAS评分均明显低于术前(均P<0.05),且术后观察组患者VAS评分明显低于对照组(P<0.05); ③与对照组患者相比,观察组患者术中、术后镇痛药物消耗量以及镇痛补救次数有明显减少(均P<0.05); ④观察组恶心、呕吐、伤口感染以及肠梗阻的例数明显较少,不良反应的总体发生率(10.00%)明显低于对照组(27.50%)(P<0.05)。结论:临床上应用腹腔镜根治术对结肠癌患者进行治疗时,采用超声引导下的腰方肌阻滞能够明显缩短患者首次排气时间、首次下床时间、苏醒时间以及拔管时间,患者围术期的疼痛状况也得到了明显改善,此外,采用超声引导腰方肌阻滞进行麻醉具有更高的安全性,可在临床治疗中进行推广应用。
Abstract:
Objective:To explore the analgesic efficacy of ultrasound-guided quadratus lumborum block during laparoscopic radical resection of colon cancer and its impact on the prognosis of patients,in order to provide a theoretical basis for anesthesia in patients with colon cancer.Methods:A total of 80 patients with colon cancer who underwent laparoscopic radical resection were selected as the research objects,and they were divided into observation group and control group according to the random number table method,40 cases in each.The control group was given general anesthesia,while the observation group was given intravenous general anesthesia after ultrasound-guided quadratus lumborum block.The first exhaust time,first ambulation time,wake-up time and extubation time were recorded and compared between the two groups.The pain status of the two groups before surgery(T0),3 hours after surgery(T1)and 6 hours after surgery(T2)were compared.The times of analgesic rescue,intraoperative analgesic drug consumption and postoperative analgesic drug consumption were recorded and compared between the two groups.The incidence of adverse reactions were compared between the two groups.Results:The operation indexes of the observation group were significantly better than those of the control group(all P<0.05).There was no significant difference in pain status between the two groups before surgery(P>0.05).The VAS scores of the two groups at 3 and 6 hours after the operation were significantly lower than those before the operation,and the VAS scores of the observation group after operation were significantly lower than those of the control group(all P<0.05).Compared with the control group,the consumption of analgesic drugs and the times of analgesic rescue in the observation group were significantly reduced during and after operation(all P<0.05).There were significantly fewer cases of nausea,vomiting,wound infection and intestinal obstruction in the observation group,and the overall incidence of adverse reactions(10.00%)was significantly lower than that(27.50%)in the control group(P<0.05).Conclusion:In clinical application of laparoscopic radical resection for the treatment of colon cancer patients,the use of ultrasound-guided quadratus lumborum block can significantly shorten the first exhaust time,first ambulation time,wake-up time and extubation time of patients,and the pain condition has also been significantly improved.The use of ultrasound-guided quadratus lumborum block for anesthesia has higher safety and can be popularized and applied in clinical treatment.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(31300675)
更新日期/Last Update: 2022-10-07