| 余桂贵.比较超声引导下腹横肌平面阻滞和局部浸润麻醉在腹膜透析管置入术中的应用[J].浙江中西医结合杂志,2018,28(6): |
| 比较超声引导下腹横肌平面阻滞和局部浸润麻醉在腹膜透析管置入术中的应用 |
| To compare the application of ultrasound-guided TAP block and Slocal infiltration anesthesia in the peritoneal dialysis tube |
| 投稿时间：2017-06-07 修订日期：2017-09-25 |
| DOI： |
| 中文关键词: 腹横肌平面阻滞 局部浸润麻醉 腹膜透析管置入术 |
| 英文关键词: |
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| 中文摘要: |
| 目的：比较超声引导下腹横肌平面阻滞与局部浸润麻醉在腹膜透析管置入术中的有效性和安全性。
方法：收集于2012年至2017年仙居县人民医院肾内科住院CKD5期患者行腹膜透析管置入术42例，随机分为两组，一组采用超声引导下腹横肌平面（TAP）阻滞，另一组采用局部浸润麻醉。用视觉（VAS）模拟评分法评估术前、术中及术后镇痛效果，进行比较。
结果：局麻组VAS评分在手术切皮时、分离皮下组织时、分离肌肉组织时、牵拉及切开腹膜时、缝皮时及术后2、4、8、12及24小时高于TAP组，两组间有显著性差异(P<0.05)。而在术前麻醉时、置管时、48小时均无统计学意义(P>0.05)。在术后使用曲马多剂量方面，局麻组术后需用曲马多来镇痛，而TAP组没有使用，两组比较有统计学意义(P<0.05)。
结论：超声引导下腹横肌平面阻滞在腹膜透析管置入术中更有效，更安全。 |
| 英文摘要: |
| 【】 Objective To compare the effectiveness and safety of ultrasound-guided Transversus abdominis plane(TAP)block and local infiltration anesthesia in the peritoneal dialysis(PD) tube. Methods Collected during 2012 to 2017 from xianju county people"s hospital urology department in hospital CKD5 period patients with peritoneal dialysis tube surgery, 42 cases were randomly divided into two groups, one group with ultrasound-guided TAP block (TAP) block, another group to use local infiltration anesthesia. The visual (VAS) simulated scoring method was used to evaluate and compare the effects of preoperative, operative and postoperative analgesia.Results VAS score in TAP group when cutting skin, subcutaneous tissue, muscle tissue it is separated;when cutting and pulling peritoneal, sewing skin and postoperative 2, 4, 8, 12 and 24 hours is higher than the TAP group, there are significant differences between the two groups (P < 0.05). No statistical significance (P > 0.05) was statistically significant in the preoperative anesthetic, in the tube, and 48 hours. In the postoperative, local infiltration anesthesia group had to be used to relieve the pain, but the TAP group was not used, and the two groups were statistically significant (P < 0.05).Conclusion Ultrasonically guided TAP block is more effective and safer in peritoneal dialysis tube placement. |
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