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外科研究与新技术（中英文）

外科研究与新技术 ›› 2022, Vol. 11 ›› Issue (1): 35-38.doi: 10.3969/j.issn.2095-378X.2022.01.009

• 论著 • 上一篇    下一篇

超声引导腹横肌平面联合髂腹下神经阻滞行腹腔镜下腹股沟疝修补术的效果及并发症观察

张国强, 赵春江, 吴海滨, 欧键莹, 黄忠阳, 黎广祥   

  1. 佛山市南海区第四人民医院麻醉科,广东 佛山 528211
  • 收稿日期:2021-08-11 出版日期:2022-03-28 发布日期:2022-08-17
  • 作者简介:张国强（1982—）,男,大学本科,副主任医师,从事临床麻醉科工作;电子信箱：anruang@163.com

Observation on effect and complications of laparoscopic inguinal hernia repair with ultrasound-guided transversus abdominis plane combined with iliohypogastric nerve block

ZHANG Guoqiang, ZHAO Chunjiang, WU Haibin, OU Jianying, HUANG Zhongyang, LI Guangxiang   

  1. Department of Anesthesiology, The Fourth People’s Hospital of Nanhai District, Foshan 528211, Guangdong, China
  • Received:2021-08-11 Online:2022-03-28 Published:2022-08-17

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摘要： 目的 观察超声引导腹横肌平面（TAP）联合髂腹下神经阻滞行腹腔镜下腹股沟疝修补术的效果及并发症。方法 选取2019年8月—2021年7月收治的80例拟行腹腔镜下腹股沟疝修补术治疗的患者并纳入研究。分作联合组及单纯组,每组各40例。单纯组实施单纯超声引导TAP阻滞,联合组则实施超声引导TAP联合髂腹下神经阻滞。对比两组围手术期不同时间点的平均动脉压（MAP）、心率（HR）以及血氧饱和度（SpO2）水平,阻滞术后不同时间点的疼痛情况,并发症发生情况。结果 联合组麻醉后10 min1以及牵拉疝囊时的MAP水平分别高于对单纯组（均P<0.05）,且两组不同时间段的HR及SPO2水平对比,差异均无统计学意义（均P>0.05）。联合组阻滞术后2、6、12、24、48 h时的VAS评分分别低于单纯组（均P<0.05）。联合组恶心呕吐、心率增快、血压升高发生率分别为2.50%、0.00%、0.00%,均低于单纯组的17.50%、10.00%、10.00%（均P<0.05）。结论 超声引导TAP联合髂腹下神经阻滞行腹腔镜下腹股沟疝修补术有利于维持患者血流动力学稳定,镇痛效果显著,且有效降低并发症发生率。

关键词: 腹股沟疝修补术, 腹横肌平面阻滞, 髂腹下神经阻滞, 超声引导, 麻醉阻滞效果

Abstract: Objective To study the effect of laparoscopic inguinal hernia repair with ultrasound-guided transversus abdominis plane （TAP） combined with iliohypogastric nerve block and to analyze the complications. Methods From August 2019 to July 2021, a total of 80 patients who planned to undergo laparoscopic inguinal hernia repair were included in this study. The patients were divided into a combined treatment group and a control group, with 40 cases in each group. The control group received ultrasound-guided TAP block, while the combined group received ultrasound-guided TAP combined with iliohypogastric nerve block. The mean arterial pressure （MAP）, heart rate （HR）, and blood oxygen saturation （SpO2） levels at different time points during perioperative period were compared between the two groups, as well as the pain and complications at different time points after block. Results The MAP levels of the combined treatment group at 10 min after anesthesia and at pulling the hernia were higher than the levels of the control group （P<0.05）, and there were no significant differences in HR and SpO2 levels between the two groups at different time periods （P>0.05）. The VAS scores of the combined treatment group at 2 h, 6 h, 12 h, 24 h, and 48 h after block were lower than the scores of the control group （P<0.05）. The incidence rates of nausea and vomiting, heart rate increase, and blood pressure increase in the combined treatment group were 2.50%, 0.00%, and 0.00%, respectively, which were all lower than those of the individual treatment group （17.50%, 10.00%, and 10.00%; P<0.05）. Conclusion Laparoscopic inguinal hernia repair with ultrasonic-guided TAP combined with iliohypogastric nerve block is beneficial to maintain hemodynamic stability, has significant analgesic effects, and can effectively reduce the incidence of complications.

Key words: Inguinal hernia repair, Transversus abdominis plane block, Iliohypogastric nerve block, Ultrasonic guidance, Anesthetic block effect

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