超声引导下腹横肌联合低位前锯肌阻滞在胆囊腹腔镜术中应用的临床效果分析

Analysis of Clinical Effect of Ultrasound-guided Lower Transverse Abdominalis Muscle Combined with Low Anterior Serrate Muscle Block in Laparoscopic Cholecystectomy

目的探讨对于腹腔镜下治疗的胆囊手术中,通过以超声引导经腹横肌阻滞(transversus abdominis plane block,TAPB)+低位前锯肌(serratus anterior plane block,SAPB)阻滞方案的价值。方法非随机选取2020年7月—2022年6月睢宁县中医院60例择期行胆囊腹腔镜手术患者为研究对象,按手术方式不同分成观察组(n=30)与对照组(n=30)。对照组患者采取TAPB,观察组采取TAPB联合SAPB。比较两组心率与平均动脉压水平、时间视觉模拟评分(Visual Analog Scoring,VAS)变化及不良反应情况。结果在手术开始以及开始后10 min,观察组的心率、平均动脉压优于对照组,差异有统计学意义(P均<0.05)。观察组术后VAS评分均优于对照组,差异有统计学意义(P均<0.05)。两组的不良反应发生情况比较[6.67%(2/30)vs 13.33%(4/30)],差异无统计学意义(χ^(2)=0.185,P=0.667)。结论应用TAPB联合SAPB对胆囊腹腔镜术的患者干预效果满意,能控制术中心率及平均动脉压指标,减轻患者术后疼痛程度,且不增加不良反应发生率。

Objective To investigate the value of ultrasound-guided transversus abdominis plane block(TAPB)+serratus anterior plane block(SAPB)in laparoscopic gallbladder surgery.Methods A total of 60 patients undergoing laparoscopic cholecystectomy in Suining County Traditional Chinese Medicine Hospital from July 2020 to June 2022 were non-randomly selected as the study objects,and divided into observation group(n=30)and control group(n=30)according to different surgical methods.Control group was treated with TAPB,observation group was treated with TAPB combined with SAPB.The changes of heart rate,mean arterial pressure,Visual Analog Scoring(VAS)and adverse reactions were compared between the two groups.Results At the beginning of operation and 10min after operation,the heart rate and mean arterial pressure in the observation group were better than those in the control group,and the differences were statistically significant(all P<0.05).Postoperative VAS scores in the observation group were better than those in the control group,and the differences were statistically significant(both P<0.05).There was no significant difference in the occurrence of adverse reactions between the two groups[6.67%(2/30)vs 13.33%(4/30)](χ^(2)=0.185,P=0.667)].Conclusion TAPB combined with SAPB has a satisfactory intervention effect on patients undergoing laparoscopic cholecystectomy,which can control operative center rate and mean arterial pressure index,reduce postoperative pain,and do not increase the incidence of adverse reactions.