不同神经阻滞方法在腹股沟疝气手术中的比较.docxVIP

不同神经阻滞方法在腹股沟疝气手术中的比较 　　[摘要]目的探討腹横肌平面阻滞与腰方肌阻滞两种不同阻滞方法在腹股沟疝修补术中的镇痛效果。方法方便选择2018年4月—2019年5月在空军特色医学中心行择期行腹股沟疝患者60例，年龄30～65岁，体重50～80kg，asa分级ⅰ或ⅱ级，所有患者根据随机表分为两组;腹横肌平面阻滞组（a组，n=30）和腰方肌阻滞组（b组，n=30）。a组采用腹横肌平面阻滞方法，而b组采用腰方肌阻滞方法，记录术前、切皮、探查疝囊和缝皮时候的wong-baker面部表情量表评分和ramsay镇静评分;记录术中、术后采取补救性镇痛措施的情况及发生并发症的情况。结果在wong-baker评分比较上腰方肌阻滞组和腹横肌平面阻滞在探查疝囊和缝皮时分别是[（2.4±0.8）分∶（1.3±0.3）分（t=7.050，p0.001）]和[（1.9±0.4）分∶（1.1±0.3）分（t=8.760，p0.001）]，显示腰方肌阻滞组具有更好的镇痛效果。结论腹股沟疝气修补术中采用腰方肌阻滞组的镇痛效果明显优于腹横筋膜平面阻滞的镇痛效果。 　　[关键词]腰肌;腹肌;腹股沟疝 　　[中图分类号]r614[文献标识码]a[文章编号]1674-0742（2020）01（c）-0072-04 　　comparativeanalysisofdifferentnerveblockmethodsinsurgicalrepairofinguinalhernia 　　haoshuai1，chenyan-ying2 　　1.departmentofanesthesiology，beijingyouanhospital，capitalmedicaluniversity，beijing，100069china;2.departmentofanesthesiology，airforcecharacteristicmedicalcenter，beijing，100142china 　　[abstract]objectivethepaperattemptstomakeacomparativeanalysisoftheanalgesiceffectproducedbytransversusabdominisplaneblockandquadratuslumbarmuscleblockinsurgicalrepairofinguinalherniacomparative.methodsconvenientselected60patientswhounderwentelectiveinguinalherniaattheairforcemedicalcenterfromapril2018tomay2019.whowere30-50yearsoldandweighedbetween50-80kgwerewaitingforsurgicalrepairofinguinalhernia.theyhadioriiasagrade.andtheywererandomlydividedintotwogroupswhichrespectivelyconsistsof30patients：thegroupareceivedtransversusabdominisplaneblock;andthegroupbreceivedquadratuslumbarmuscleblock.doctorsrecordedthewong-bakerfacesratingscalescoresofthepatientsbeforetheoperation，andduringtheskinincision，detectionofhernialsacandsuturingphases，aswellasramsaysedationscores.thedoctorsalsorecordedtheremedialanalgesicmeasurestakenduringandaftertheoperation，aswellascomplicationsfromtheoperation.resultsinthewong-bakerscore，theupperquadratuslumborumblockgroupandthemusculustrasversusabdominisblockwere[（2.4±0.8）points∶（1.3±0.3）points（t=7.050，p0.001）]and[（1.9±0.4）points∶（1.1±0.3）points（t=8.760，p0.001）]atthetimeofinvestigatingthehernias