摘要
目的分析侧入路穿刺对腰硬联合麻醉脑脊液引流的影响。方法选取2018年3月-2019年2月收治的拟行盆腔、下肢等手术且符合腰硬联合麻醉指征的72例患者按随机数字表法分成观察组和对照组,每组36例。观察组采用侧入路行腰硬联合麻醉,对照组采用正中入路行腰硬联合麻醉。对比两组一次腰穿成功率、脑脊液引流不畅和置管阻力发生率、操作时间及术后腰痛情况。结果观察组一次腰穿成功率91.67%,明显高于对照组72.22%(χ^2=4.600,P<0.05);观察组脑脊液引流不畅发生率5.56%,明显低于对照组22.22%(χ^2=4.180,P<0.05);观察组置管阻力发生率8.33%,明显低于对照组27.78%(χ^2=4.600,P<0.05);观察组操作时间(1.06±0.28)min,明显短于对照组(1.29±0.35)min(t=3.079,P<0.05);观察组术后24 h腰痛得分(5.79±1.27)分,明显低于对照组(6.92±1.34)分(t=3.672,P<0.05);观察组术后48 h腰痛得分(4.91±1.30)分,明显低于对照组(5.96±1.45)分(t=3.235,P<0.05);观察组术后出院时腰痛得分(0.62±0.23)分,明显低于对照组(0.87±0.37)分(t=3.443,P<0.05)。结论侧入路穿刺能有效提高腰硬联合麻醉患者脑脊液引流效果,并减少置管阻力和减轻术后腰痛,缩短操作时间。
Objective To analyze the effect of lateral approach puncture on cerebrospinal fluid drainage in combined spinal and epidural anesthesia. Methods 72 patients who underwent pelvic and lower extremity surgery from March 2018 to February 2019 and who met the indications for combined spinal and epidural anesthesia were randomly divided into observation group and control group, with 36 cases in each group. The observation group was treated with lumbar and hard anesthesia with a lateral approach, and the control group was treated with a median approach for lumbar and spinal anesthesia. The success rate of waist wear, cerebrospinal fluid drainage and catheterization resistance, operation time and postoperative low back pain were compared between the two groups. Results The success rate of lumbar puncture was 91.67% in the observation group, which was significantly higher than 72.22% in the control group(χ^2=4.600, P<0.05). The incidence of cerebrospinal fluid drainage was 5.56% in the observation group, which was significantly lower than 22.22% in the control group(χ^2=4.180, P<0.05);the incidence of tube placement resistance in the observation group was 8.33%, which was significantly lower than that in the control group 27.78%(χ^2=4.600, P<0.05). The operation time of the observation group was(1.06±0.28) min, which was significantly shorter than the control group(1.29 ±0.35)min(t=3.079, P<0.05);the low back pain score of the observation group at 24 h after operation was(5.79±1.27)points, which was significantly lower than that of the control group(6.92±1.34)points(t=3.672, P<0.05). The observation group had a low back pain score of(4.91±1.30)points at 48 h after operation, which was significantly lower than that of the control group(5.96±1.45) points(t=3.235, P<0.05). The observation group had a low back pain score(0.62±0.23) points after discharge, significantly lower than the control group(0.87±0.37) points(t=3.443,P<0.05). Conclusion The lateral approach puncture can effectively improve the cerebrospinal fluid drainage effect in patients with combined spinal and epidural anesthesia, reduce the tube placement resistance and reduce postoperative low back pain, and shorten the operation time.
作者
付艳艳
FU Yan-yan(Binzhou Medical College,Yantai,Shandong Province,264003 China)
出处
《世界复合医学》
2019年第12期47-49,共3页
World Journal of Complex Medicine
关键词
侧入路
腰硬联合麻醉
脑脊液引流
Lateral approach
Combined spinal and epidural anesthesia
Cerebrospinal fluid drainage
