摘要
目的 探讨超声引导下腹横纹肌阻滞复合全麻在肝细胞癌手术中的应用效果。方法 该研究为前瞻性随机对照研究。依据随机数表法将2022年1月至2023年6月拟行腹腔镜肝切除术治疗的82例患者分为对照组(41例,全麻)和观察组(41例,全麻+超声引导下腹横纹肌阻滞)。比较2组麻醉相关指标,术后6 h、12 h、24 h时疼痛程度[视觉模拟评分法(VAS)评分],麻醉前(T_(0))、手术开始后30 min(T_(1))和术毕(T_(2))时血流动力学指标,术前、术后6 h和术后12 h时应激反应,以及2组患者术后不良反应发生情况。结果 对照组术中瑞芬太尼、丙泊酚使用剂量多于观察组(P<0.05)。术后6 h、12 h、24 h时,对照组VAS评分高于观察组(P<0.05)。T_(1)、T_(2)时,对照组平均动脉压、心率均高于T_(0),且高于观察组(P<0.05)。术后6 h、12 h,对照组血清皮质醇、去甲肾上腺素和肾上腺素水平高于观察组(P<0.05)。对照组术后不良反应总发生率高于观察组(P<0.05)。结论 超声引导下腹横纹肌阻滞复合全麻在肝细胞癌手术中的应用效果显著,可减少术中麻醉药物使用剂量,降低患者术后疼痛程度和应激反应,有效维持患者术中血流动力学稳定,降低患者不良反应发生率。
Objective To explore the application effect of ultrasound-guided abdominal striated muscle block combined with general anesthesia in patients undergoing hepatocellular carcinoma surgery.Methods This study was a prospective randomized controlled study.Based on the random number table method,82 patients who underwent laparoscopic liver resection were divided into the control group(41 cases,general anesthesia)and the observation group(41 cases,general anesthesia+abdominal striated muscle block).The anesthesia-related indexes,pain degree[visual analogue scale(VAS)score]at 6 h,12 h and 24 h after operation,hemodynamic indexes before anesthesia(T_(0)),30 min after operation(T_(1))and at the end of operation(T_(2)),stress response before operation,6 h and 12 h after operation,and postoperative adverse reactions were compared between the 2 groups.Results The control group received more doses of remifentanil and propofol during surgery than the observation group(P<0.05).At 6 h,12 h,and 24 h after surgery,the VAS score in the control group was higher than that in the observation group(P<0.05).At T_(1) and T_(2),the average arterial pressure and heart rate in the control group were higher than T_(0) and higher than those in the observation group(P<0.05).At 6 h and 12 h after surgery,the serum cortisol,norepinephrine,and adrenaline levels in the control group were higher than those in the observation group(P<0.05).The total incidence of postoperative adverse reactions in the control group was higher than that in the observation group(P<0.05).Conclusion The application of ultrasound-guided abdominal striated muscle block combined with general anesthesia in patients undergoing hepatocellular carcinoma surgery has a significant effect.It can reduce the dosage of anesthesia drugs used during surgery,reduce postoperative pain and stress response,effectively maintain hemodynamic stability during surgery,and reduce the incidence of adverse reactions in patients.
作者
葛军甫
王彤
韩学昌
张亚杰
GE Junfu;WANG Tong;HAN Xuechang(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471003)
出处
《实用癌症杂志》
2025年第7期1170-1174,共5页
The Practical Journal of Cancer
基金
河南省医学科技攻关计划项目(编号:LHGJ20220691)。
关键词
超声引导
腹横纹肌阻滞
全身麻醉
肝细胞癌
Ultrasound guidance
Abdominal striated muscle block
General anesthesia
Hepatocellular carcinoma
