摘要
目的探讨单点单次胸椎旁阻滞应用于经皮肾镜碎石取石术的临床效果。方法选取2019年9月至2020年2月大连大学附属新华医院麻醉科收治的60例经皮肾镜碎石取石术患者作为研究对象,采用随机数字表法分为对照组(30例)与观察组(30例)。对照组采用椎管内麻醉术方法,观察组采用超声引导单点单次胸椎旁阻滞术。比较两组的手术相关指标,视觉模拟评分法(VAS)评分,麻醉前(T_(0))、麻醉后10 min(T_(1))、建立碎石通道后(T_(2))、碎石开始后10 min(T_(3))、结束(T_(4))时的生命体征。结果观察组手术时间、术后排气时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术前,两组VAS评分比较,差异无统计学意义(P>0.05);术后6、12、24 h,两组VAS评分低于本组术前,且观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。T_(0)时,两组平均动脉压(MAP)、心率(HR)比较,差异无统计学意义(P>0.05);观察组T_(1)、T_(4)的MAP高于对照组,T_(2)、T_(3)的MAP低于对照组;观察组T_(1)的HR高于对照组,T_(2)~T_(4)的HR低于对照组,差异有统计学意义(P<0.05)。结论超声引导单点单次胸椎旁阻滞应用于经皮肾镜碎石取石术后治疗可缩短手术时间及住院时间,减少出血量,可降低疼痛,对动脉压及心率影响较小。
Objective To investigate the clinical effect of single point and single paravertebral block after percutaneous nephrolithotomy.Methods A total of 60 percutaneous nephrolithotomy patients admitted to the Department of Anesthesiology,Xinhua Hospital Affiliated to Dalian University from September 2019 to February 2020 were selected as the study subjects,and were divided into control group(30 cases)and observation group(30 cases)by random number table method.The control group was treated with intraspinal anesthesia,and the observation group was treated with ultrasound-guided single point single paravertebral block.Surgical indicators,visual analogue scale(VAS)score,vital signs before anesthesia(T_(0)),10 min after anesthesia(T_(1)),after the establishment of lithotripsy channel(T_(2)),10 min after the beginning of lithotripsy(T_(3)),and at the end of lithotripsy(T_(4))were compared between the two groups.Results The operation time,postoperative exhaust time and hospital stay in the observation group were shorter than those in the control group,and the amount of intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).Preoperative comparison of VAS scores between the two groups showed no statistical significance(P>0.05).At 6,12 and 24 h postoperatively,VAS scores in both groups were lower than those before operation,and VAS score in observation group was lower than that in control group,the differences were statistically significant(P<0.05).At T_(0),there were no significant differences in mean arterial pressure(MAP)and heart rate(HR)between the two groups(P>0.05).The MAP of T_(1)and T_(4)in observation group were higher than those in control group,while the MAP of T_(2)and T_(3)were lower than those in control group,the HR of T_(1)in observation group was higher than that in control group,and the HR of T_(2)-T_(4)were lower than those in control group,the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided single point single thoracic paravertebral block can shorten the operation time and hospital stay,reduce the amount of bleeding,reduce pain,and have little effect on arterial pressure and heart rate.
作者
孔祥云
隋成
周晶
崔金花
KONG Xiangyun;SUI Cheng;ZHOU Jing;CUI Jinhua(Department of Anesthesiology,Xinhua Hospital Affiliated to Dalian University,Liaoning Province,Dalian116021,China)
出处
《中国当代医药》
CAS
2022年第13期99-102,共4页
China Modern Medicine
关键词
超声引导
单点单次胸椎旁阻滞
经皮肾镜取石术
镇痛
Ultrasound guidance
Single point single parathoracic block
Percutaneous nephrolithotomy
Analgesia
作者简介
孔祥云(1989-),女,汉族,硕士,研究方向:器官保护。
