摘要
目的探讨腹横筋膜阻滞对腹腔镜结直肠癌根治术术后镇痛及患者恢复情况的影响。方法 63例在我院外科行腹腔镜结直肠手术患者,随机分为对照组32例和TAP组31例,对照组行静脉镇痛,TAP组行腹横筋膜阻滞加静脉镇痛。手术结束后记录术后肠道功能恢复时间、进食进水时间、下床活动时间、手术时间、自主呼吸恢复时间、苏醒时间及拔管时间。同时于术后苏醒时刻、术后12h、术后24h评估患者VAS疼痛评分,并观察患者术后并发症。结果 TAP组自主呼吸时间、苏醒时间均低于对照组,差异有统计学意义(t=6.99、6.23,P<0.05),手术时间、拔管动时间与对照组相比,差异无统计学意义(t=1.23、0.97,P>0.05);TAP组肠道功能恢复时间、进食时间、下床活动时间均低于对照组,差异有统计学意义(t=16.32、21.23、18.97,P<0.05);于术后苏醒时刻、术后12h、术后24h,TAP组无痛例数均多于对照组,轻、中度例数均少于对照组,重度疼痛例数与对照组相同,两组疼痛程度构成比差异有统计学意义(X^2=13.32、21.65、17.89,P<0.05);TAP组恶心呕吐、下肢运动感觉障碍、头晕例数均低于对照组,差异有统计学意义(X^2=14.54、17.34、21.43,P<0.05),皮肤瘙痒、呼吸抑制例数与对照组相同差异无统计学意义(X^2=0.001、0.001,P>0.05)。结论腹横筋膜阻滞应用于结直肠癌根治术能有效减轻患者痛苦、减少并发症的发生、促进患者术后恢复,值得在临床上推广应用。
Objective To investigate the effect of abdominal fascia block on postoperative analgesia and recovery of laparoscopic radical resection of colorectal cancer.Methods Sixty-three patients underwent laparoscopic colorectal surgery in our hospital were randomly divided into control group（ 32 cases） and TAP group（ 31cases）.The control group was treated with intravenous analgesia.TAP group received abdominal fascia block and intravenous analgesia.At the end of the operation,the recovery time of intestinal function,the time of feeding,the time of getting out of bed,the time of operation,the recovery time of spontaneous breathing,the time of awakening and the time of extubation were all recorded.At the same time,the VAS pain score was evaluated at the time of awakening,12 hours postoperatively,24 hours postoperatively,and the postoperative complications were observed.Results The spontaneous breathing time and awakening time of TAP group were lower than those of the control group（ t = 6. 99、6. 23,P〈0. 05）.There was no significant difference in operation time and extubation time compared with the control group（ t = 1. 23、0. 97,P〈0. 05）.The recovery time of intestinal function,the time of eating and the time of getting out of bed in the TAP group were significantly lower than those in the control group（ t = 16. 32、21. 23、18. 97,P〈0. 05）. After the postoperative awakening time,12 hours postoperatively and 24 hours after operation,the number of painless cases in TAP group was higher than that in the control group.The number of mild and moderate pain cases was less than that of the control group.The number of severe pain cases was the same as that of the control group（X^2 = 13. 32、21. 65、17. 89,P〈0. 05）. The number of nausea and vomiting,lower extremity motor sensory disturbances and dizziness in TAP group were lower than those in control group,the difference was statistically significant（ X^2= 14. 54、17. 34、21. 43,P〈0. 05）.There was no significant difference between the number of skin itching and respiratory depression（ X^2= 0. 001、0. 001,P〈0. 05）.Conclusion The application of abdominal fascia block in colorectal cancer can effectively reduce the pain of patients,reduce the incidence of complications and promote the recovery of patients,it is worthy of clinical application.
出处
《四川医学》
CAS
2017年第8期891-895,共5页
Sichuan Medical Journal
基金
南通市科技项目(编号:HS2014051)
关键词
腹横筋膜阻滞
结直肠癌根治术
镇痛
恢复
abdominal transverse fascia block
colorectal cancer radical surgery
analgesia
recovery
