基于三维数字化的腹横筋膜平面精准阻滞麻醉在剖宫产手术的临床研究

Clinical study of anaesthesia based on 3D digital transversus abdominis planeblock anesthesia in cesarean section

目的 探讨研究基于三维数字化的腹横筋膜平面(TAP)精准阻滞麻醉在剖宫产手术的临床效果.方法 选取2019年6~11月来我院进行剖宫产手术孕妇96例作为研究对象,按照随机数字表法分为对照组(n=48)和观察组(n=48).两组均采用超声引导TAP阻滞方法用于剖宫产术后的镇痛,其中观察组采用腹壁结构的三维数字化重建,导航下行TAP阻滞麻醉,对照组采用超声引导常规给药行阻滞麻醉,治疗后对患者治疗效果进行评估,比较两组镇痛效果术后首次下床、苏醒时间以及不良反应.结果 观察组术后VAS评分低于对照组(P<0.05);观察组术后首次下床时间和苏醒时间早于对照组(P<0.05);两组术后24h VAS评分均最高,之后随时间疼痛逐渐减轻(P<0.05).观察组不良反应发生率明显低于对照组(P<0.05).结论 将三维数字化的TAP精准阻滞麻醉应用于剖宫产手术,极大地改善了患者预后,效果显著,对剖宫产孕妇术后起到有效的镇痛作用,减少了产妇术后的恢复时间,减少麻醉药物不良反应的发生,提高了用药安全性,值得推广应用.

Objective To investigate the clinical effect of 3D digital transversus abdominis planeblock(TAP)anesthesia in cesarean section.Methods 96 patients who underwent cesarean section in our hospital from June to November 2019 were selected as subjects.They were divided into the control group(n=48)and the observation group(n=48)by using the random number table method.Both groups used the ultrasound-guided TAP for analgesia after cesarean section.The observation group used 3D digital reconstruction of the abdominal wall structure,TAP anesthesia was performed under navigation;the control group used ultrasound-guided conventional drug delivery for block anesthesia.The treatment effects of the two groups were evaluated,and the analgesic effects,the first time getting out of bed,awake time and adverse reactions were compared between the two groups.Results The VAS score of the observation group was lower than that of the control group(P<0.05);The first time getting out of bed and the awake time of the observation group were earlier than those of the control group(P<0.05).The VAS score at 24 h after surgery was the highest in both groups,and the pain gradually decreased over time(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion The application of 3D digital TAP anesthesia in cesarean section surgery has greatly improved the prognosis of patients with significant effects.It has an effective analgesic effect on cesarean patients and reduces postoperative recovery time,reduce the incidence of adverse reactions,improve the safety of medication,and is worth promotion and application.