[1]梅 雷.超声引导腹横肌平面阻滞对结直肠癌患者开腹手术后快速康复的影响[J].新乡医学院学报,2021,38(9):876-879.[doi:10.7683/xxyxyxb.2021.09.016]
 MEI Lei.Effect of ultrasound-guided transabdominal transverse plane block on rapid recovery of colorectal cancer patients after operation[J].Journal of Xinxiang Medical University,2021,38(9):876-879.[doi:10.7683/xxyxyxb.2021.09.016]
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超声引导腹横肌平面阻滞对结直肠癌患者开腹手术后快速康复的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年9
页码:
876-879
栏目:
临床研究
出版日期:
2021-09-05

文章信息/Info

Title:
Effect of ultrasound-guided transabdominal transverse plane block on rapid recovery of colorectal cancer patients after operation
作者:
梅 雷
(信阳市中心医院麻醉科,河南 信阳 464000)
Author(s):
MEI Lei
(Department of Anesthesia,the Central Hospital of Xinyang,Xinyang 464000,Henan Province,China)
关键词:
神经传导阻滞结直肠癌术超声引导快速康复
Keywords:
nerve conduction blockcolorectal surgeryultrasonic guidancerapid rehabilitation
分类号:
R735.33
DOI:
10.7683/xxyxyxb.2021.09.016
文献标志码:
A
摘要:
目的 评价超声引导腹横肌平面阻滞(TAP)对结直肠癌患者开腹手术后快速康复的影响。方法 将2018年1月至2020年3月信阳市中心医院收治的结直肠癌开腹手术患者83例随机分为对照组(n=41)和观察组(n=42)。对照组患者单纯采用静脉镇痛泵镇痛,观察组患者采用静脉镇痛泵和双侧TAP阻滞。记录2组患者术后24 h内舒芬太尼的使用量、自控镇痛(PCA)按压次数。术后2、6、12、24 h,分别采用视觉模拟量表(VAS)和Ramsay镇静评分评估患者的疼痛情况和镇静情况;分别于术前及术后1、3、7 d采用酶联免疫吸附试验法检测2组患者血清中可溶性上皮型钙黏蛋白(sE-cad)水平,采用流式细胞仪检测全血单核细胞人白血病抗原-DR(mHLA-DR)水平。结果 观察组患者术后舒芬太尼使用量和PCA 按压次数显著少于对照组,镇痛满意度显著高于对照组(P<0.05)。观察组患者术后各时间点的VAS和Ramsay评分均显著低于对照组(P<0.05)。观察组患者首次下床活动、导尿管拔除时间及术后住院时间均显著短于对照组(P<0.05);2组患者肛门首次排气时间比较差异无统计学意义(P>0.05)。2组患者术前血清sE-cad水平及全血mHLA-DR水平比较差异无统计学意义(P>0.05)。术后1 d,观察组患者血清sE-cad水平与对照组比较差异无统计学意义(P>0.05)术后3、7 d,观察组患者血清sE-cad水平显著低于对照组(P<0.05)。观察组患者术后各时间点全血mHLA-DR水平均显著高于对照组(P<0.05)。对照组和观察组患者总不良反应发生率分别为43.90%(18/41)、23.81%例(10/42),2组患者总不良反应发生率比较差异无统计学意义(χ2=1.205,P>0.05)。结论 TAP阻滞对结直肠癌开腹手术的镇疼效果好,有利于患者术后快速康复。
Abstract:
Objective To analyze the effect of ultrasound-guided transabdominal transverse plane block(TAP) on the rapid rehabilitation of patients with colorectal cancer after operation.Methods Eighty-three patients with open operation for colorectal cancer admitted to the Central Hospital of Xinyang from January 2018 to March 2020 were selected and randomly divided into the control group(n=41) and the observation group(n=42).Patients in the control group were given only intravenous analgesia pump,while the patients in the observation group were given intravenous analgesia pump and bilateral TAP block.The dosage of sufentanil and the number of patient controlled analgesia(PCA) compressions were recorded in the two groups within 24 h after operation.The pain and sedation of patients at 2,6,12,24 h after operation were evaluated by visual analogue scale(VAS) and Ramsay sedation scores.Before operation and 1,3,7 d after operation,the level of serum soluble epicyte cadherin(sE-cad) of patients was detected by enzyme-linked immunosorbent assaythe level of whole blood monocyte human leukocyte antigen-DR(mHLA-DR) was detected by flow cytometry.Results The usage of sufentanil after operation and the times of PCA compressions of patients in the observation group were significantly lower than those in the control group,and the analgesic satisfaction was significantly higher than that in the control group(P<0.05).The VAS and Ramsay scores of patients in the observation group were lower than those in the control group(P<0.05).The first ambulation,catheter extraction time and postoperative hospital stay of patients in the observation group were significantly shorter than those in the control group(P<0.05)there was no significant difference in the first anal exhaust time of patients between the two groups(P>0.05).There was no significant difference in serum sE-cad level and whole blood mHLA-DR level of patients between the two groups before operation(P>0.05).At 1 d after operation,there was no significant difference in serum sE-cad level of patients between the observation group and the control group(P>0.05)at 3,7 d after operation,the level of serum sE-cad of patients in the observation group was significantly lower than that in the control group(P<0.05).The level of whole blood mHLA-DR of patients in the observation group was significantly higher than that in the control group at all time points after operation(P<0.05).The total incidence of adverse reactions of patients in the control group and observation group were 43.90%(18/41) and 23.81%(10/42),respectivelythere was no significant difference in the total incidence of adverse reactions between the two group(χ2=1.205,P<0.05).Conclusion TAP block has a good analgesic effect on open operation of colorectal cancer,which is conducive to the rapid recovery of patients after operation.

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更新日期/Last Update: 2021-09-05