医学临床研究
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医学临床研究  2019, Vol. 36 Issue (2): 243-245    DOI: 10.3969/j.issn.1671-7171.2019.02.011
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超声引导下腹横肌平面阻滞联合腰-硬麻醉对下腹部手术患者术后疼痛及CRP、IL-6水平影响
尚荻
辽宁省辽阳市第三人民医院,辽宁 辽阳 111000
Effect of Ultrasound-guided Transversus Abdominis Plane Block Combined with Spinal Epidural Anesthesia on Postoperative Analgesia and Levels of Serum CRP and IL-6 in Patients with Lower Abdominal Surgery
SHANG Di
The Third People's Hospital of Liaoyang,Liao Ning, 111000 China
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摘要 目的 探讨超声引导下腹横肌平面阻滞联合腰-硬麻醉对下腹部手术患者术后疼痛及C反应蛋白(CRP)、白细胞介素6(IL-6)水平的影响。方法 选取2016年1月至2017年8月本院收治的下腹部手术患者80例作为研究对象,ASA分级为Ⅰ~Ⅱ级,均行腰-硬麻醉,随机分为对照组及观察组两组各40例。对照组接受经静脉患者自控镇痛(PCIA),观察组接受超声引导下腹横肌平面阻滞+PCIA。比较两组患者术后不同时刻的视觉模拟评分(VAS),Ramsay镇静评分,CRP、IL-6水平等指标。结果 观察组术后2 h、6 h、24 h时VAS评分均明显低于对照组,差异均有统计学意义(P<0.05),两组患者术后48 h时VAS评分比较差异无统计学意义(P>0.05);两组患者术后不同时刻Ramsay镇静评分比较差异无统计学意义(P>0.05);观察组术后6 h、24 h、48 h血清CRP、IL-6水平均明显低于对照组,差异均有统计学意义(P<0.05);观察组术后24 h镇痛泵按压次数、舒芬太尼用量均明显低于对照组,差异均有统计学意义(P<0.05)。结论 超声引导下行腹横肌平面阻滞提高了腰-硬麻醉下腹部手术患者术后24 h镇痛效果,减轻了炎症应激反应,值得临床推广应用。
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尚荻
关键词 麻醉药局部/治疗作用    
AbstractObjective To analyze the effect of ultrasound-guided transversus abdominis plane block combined with spinal epidural anesthesia on postoperative analgesia, serum CRP and IL-6 Levels in patients undergoing lower abdominal surgery. Methods A total of 80 patients with lower abdominal surgery who were treated in our hospital from January 2016 to August 2017 were selected as the research objects. All patients (ASAⅠor Ⅱ grade) underwent spinal epidural anesthesia. According to random number table method, patients were divided into two groups with 40 cases in each (n=40): the conventional group received patient-controlled intravenous analgesia (PCIA) and the study group received ultrasound guided transversus abdominis plane block +PCIA. The VAS, Ramsay sedation scores, serum C reactive protein (CRP) and interleukin-6 (IL-6) levels were measured at different times after operation and compared between the two groups. Results The VAS scores at the 2, 6 and 24 h after operation in the study group were significantly lower than those in the conventional group, the differences were statistically significant (P<0.05). There was no significant difference in VAS score between the two groups at 48 h after operation (P>0.05). There were no significant differences in Ramsay sedation score between the two groups at different time points after operation (P>0.05). The serum levels of CRP and IL-6 in the study group were significantly lower than those in the conventional group at 6, 24 and 48 h after operation. The differences were statistically significant (P<0.05). The number of pressing pump and sufentanil in the study group 24 h after operation were significantly lower than those in the conventional group, and the differences were statistically significant (P<0.05). Conclusion Ultrasound-guided transversus abdominis plane block improves the analgesic effect and alleviates inflammatory stress response 24 hours post-operation in patients with lower abdominal surgery.
Key wordsAnesthetics    Local/TU
收稿日期: 2018-12-05     
PACS:  R971.2  
引用本文:   
尚荻. 超声引导下腹横肌平面阻滞联合腰-硬麻醉对下腹部手术患者术后疼痛及CRP、IL-6水平影响[J]. 医学临床研究, 2019, 36(2): 243-245.
SHANG Di. Effect of Ultrasound-guided Transversus Abdominis Plane Block Combined with Spinal Epidural Anesthesia on Postoperative Analgesia and Levels of Serum CRP and IL-6 in Patients with Lower Abdominal Surgery. JOURNAL OF CLINICAL RESEARCH, 2019, 36(2): 243-245.
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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.02.011     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I2/243
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