摘要
目的观察超声引导下经腹横肌平面阻滞应用于腹膜透析置管术的效果。方法回顾性分析2015年1月至2017年1月上海市第八人民医院收治的行腹膜透析置管术治疗的40例肾衰竭患者的临床资料,根据麻醉方式不同分为对照组和观察组,各20例。对照组给予气管内插管全身麻醉;观察组行超声引导下腹横筋膜平面神经阻滞麻醉。记录两组患者手术期间平均动脉压、心率、脉搏血氧饱和度的变化情况;并统计两组血管活性药物应用情况及术后不良反应发生率。结果对照组诱导后1 min、10 min平均动静脉压及心率呈下降趋势,但注射麻醉药物20 min时恢复入室水平;观察组平均动脉压及心率虽有波动,但较平稳,两组平均动脉压和心率组间、时点间、组间·时点间交互作用比较差异有统计学意义(P<0.01)。观察组麻黄素及阿托品用药总量低于对照组[(12.55±3.46)mg比(18.41±4.17)mg;(0.75±0.22)mg比(1.38±0.45)mg](均P<0.05)。观察组总不良反应发生率低于对照组[25.0%(5/20)比40.0%(12/20)](P<0.05)。结论超声引导下腹横筋膜平面神经阻滞麻醉应用于腹膜透析置管术平均动脉压力及心率均平稳,可减少血管活性药物使用,且安全。
Objective To observe the effect of ultrasound guided transversus abdominis plane block applied to peritoileal dialysis catheter. Methods The clinical data of 40 patients with renal failure treated by peritoneal dialysis in Shanghai Eighth People＇s Hospital from Jan. 2015 to Jan. 2017 were retrospectively analyzed. They were divided into a control group and an observation group according to the mode of anesthesia with 20 eases in each group. The control group received endotrachealintubation general anesthesia, while the observation group received ultrasound guided transversus fascia plane nerve block anesthesia. The mean arterial pressure and heart rate, pulse oxygen saturation （SpO2 ） changes of the two groups during operation were recorded; and statistics of vasoactive drugs application and the incidence of postoperative adverse reactions of the two groups were obtained. Results The control group＇s average dynamic venous pressure and heart rate decreased 1 rain, 10 rain after induction,but recovered to the entering room levelat 20 min after injection; there was fluctuations in mean arterial pressure and heart rate, but was generally stable, the differences between groups, time points, and group · time point interaction were statistically significant（ P 〈 0. 01 ）. The ephedrine and atropine dose of the observation group was lower than that of the control group [ （ 12. 55± 3.46） rag vs （ 18. 41 ±4. 17） mg; （0. 75 ±0. 22） rag vs （ 1.38 ±0. 45） mg] （P 〈0. 01）. The total adverse reaction rate of the observation group was lower than that of the control group [25.0%（5/20） vs 40.0% （12/20） ] （P 〈0.05）. Conclusion Ultrasound guided transversus fascia plane nerve block anesthesia in peritoneal dialysis catheter has stable mean arterial pressure and heart rate ,which can reduce vascular active drug use with good safety.
出处
《医学综述》
2017年第16期3321-3324,共4页
Medical Recapitulate
