超声引导下不同入路腹横肌平面阻滞对妇科手术快速康复应用效果评价(1)
[摘要] 目的 分析超声引导下不同入路腹横肌平面阻滞(TAPB)对妇科手术快速康復的应用效果。 方法 便利选择2017年8月—2018年8月该院妇科收治的100例腹腔镜手术患者进行观察，随机分组法分成观察组、对照组，各50例。观察组行全麻超声引导下Petit三角、肋缘下入路TAPB，对照组行全麻超声引导下肋缘下入路TAPB，比较两组患者的镇痛满意度、镇痛泵按压次数、不良反应发生率，拔管后不同时段疼痛视觉模拟量表(VAS评分)、镇静程度(Ramsay评分)情况。 结果 观察组镇痛满意度(100.0%)明显优于对照组(84.0%)， 差异有统计学意义(χ2=6.657 6，P<0.05);观察组镇痛泵按压次数(4.5±1.3)次明显低于对照组(10.3±2.2)次，差异有统计学意义(t=16.049 3，P<0.05);观察组不同时段VAS评分均低于对照组，差异有统计学意义(P<0.05)，两组不同时段Ramsay评分、不良反应比较差异无统计学意义(P>0.05)。 结论 超声引导下不同入路TAPB对妇科腹腔镜手术患者的镇静效果均较好，不良反应少。Petit三角和肋缘下入路疗效明显优于肋缘下入路，患者疼痛轻，镇痛泵按压次数少，患者的满意度更高，加快了术后康复速度。
[关键词] 妇科手术;超声引导;快速康复;不同入路;TAPB;应用效果
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2019)04(a)-0189-03
[Abstract] Objective To analyze the effect of ultrasound-guided transabdominal transverse plane block (TAPB) on the rapid rehabilitation of gynecological surgery. Methods A total of 100 patients undergoing laparoscopic surgery in our hospital from August 2017 to August 2018 were convenient selected and enrolled. The patients were divided into observation group and control group by 50 cases. The observation group underwent general anesthesia-guided Petit triangle and ribbed approach TAPB， and the control group underwent general anesthesia-guided subcostal approach TAPB. The analgesic satisfaction， analgesic pump compression times， and poor group were compared between the two groups. The incidence of reaction， visual analog scale (VAS score) and sedation (Ramsay score) at different time points after extubation were observed. Results The analgesic satisfaction of the observation group (100.0%) was significantly better than that of the control group (84.0%). The difference was statistically significant (χ2=6.657 6， P<0.05). The number of analgesic pump compressions in the observation group was (4.5±1.3) times. Compared with the control group (10.3±2.2) times， the difference was statistically significant (t=16.049 3， P<0.05). The VAS scores of the observation group were lower than the control group at different time pointsthe difference was statistically significant(P<0.05). The Ramsay scores of the two groups at different time points were not significant in adverse reactions (P>0.05). Conclusion Ultrasound-guided TAPB has better sedative effects on gynecologic laparoscopic surgery and less adverse reactions. The efficacy of Petit's triangle and costal approach is significantly better than that of the costal approach. The patient's pain is light， the analgesic pump presses less， the patient's satisfaction is higher， and the postoperative recovery speed is accelerated., 百拇医药(贺奕博)
[关键词] 妇科手术;超声引导;快速康复;不同入路;TAPB;应用效果
[中图分类号] R614 [文献标识码] A [文章编号] 1674-0742(2019)04(a)-0189-03
[Abstract] Objective To analyze the effect of ultrasound-guided transabdominal transverse plane block (TAPB) on the rapid rehabilitation of gynecological surgery. Methods A total of 100 patients undergoing laparoscopic surgery in our hospital from August 2017 to August 2018 were convenient selected and enrolled. The patients were divided into observation group and control group by 50 cases. The observation group underwent general anesthesia-guided Petit triangle and ribbed approach TAPB， and the control group underwent general anesthesia-guided subcostal approach TAPB. The analgesic satisfaction， analgesic pump compression times， and poor group were compared between the two groups. The incidence of reaction， visual analog scale (VAS score) and sedation (Ramsay score) at different time points after extubation were observed. Results The analgesic satisfaction of the observation group (100.0%) was significantly better than that of the control group (84.0%). The difference was statistically significant (χ2=6.657 6， P<0.05). The number of analgesic pump compressions in the observation group was (4.5±1.3) times. Compared with the control group (10.3±2.2) times， the difference was statistically significant (t=16.049 3， P<0.05). The VAS scores of the observation group were lower than the control group at different time pointsthe difference was statistically significant(P<0.05). The Ramsay scores of the two groups at different time points were not significant in adverse reactions (P>0.05). Conclusion Ultrasound-guided TAPB has better sedative effects on gynecologic laparoscopic surgery and less adverse reactions. The efficacy of Petit's triangle and costal approach is significantly better than that of the costal approach. The patient's pain is light， the analgesic pump presses less， the patient's satisfaction is higher， and the postoperative recovery speed is accelerated., 百拇医药(贺奕博)