摘要
目的 对比超声引导下骶管神经阻滞与传统解剖定位在肛周手术中的应用效果,探讨超声引导的优势。方法 选取2023年1月至2024年9月本院择期行肛周手术100例患者作为研究对象,随机分为观察组U组(超声引导下骶管阻滞)和对照组A组(传统解剖定位骶管阻滞)各50例。观察并记录两组穿刺操作时间、麻醉起效时间、痛觉消失时间、穿刺成功率、肛门松弛情况、穿刺并发症、双下肢运动功能评分(Bromage评分)情况、尿潴留情况及术后疼痛恢复时间等指标。结果 U组操作时间及术后疼痛恢复时间均显著长于A组,差异均有统计学意义(P<0.05),U组麻醉起效时间、痛觉消失时间均显著短于A组,差异有统计学意义(P<0.05);U组穿刺成功率明显高于A组,差异有统计学意义(P<0.05),U组穿刺出血及总并发症发生率均低于A组,差异有统计学意义(P<0.05);U组与A组在Ⅲ级麻醉上差异有统计学意义(P<0.05),麻醉优良与失败上差异有统计学意义(P<0.05);U组与A组在双下肢运动功能评级比较差异均没有统计学意义(P>0.05)。结论 超声引导下骶管神经阻滞在肛周手术中具有穿刺成功率高、麻醉起效快、痛觉消失迅速、肛门松弛良好、穿刺并发症少、术后镇痛时间长等优势。
Objective To compare the application effect of sacral canal nerve block under ultrasound guidance and traditional anatomical localization in perianal surgery,and explore the advantages of ultrasound guidance.Methods 100 patients who underwent elective perianal surgery in our hospital from January 2023 to September 2024 were selected as research objects,and randomly divided into observation group U(ultrasound-guided sacral canal block)and control group A(traditional anatomical location sacral canal block),50 cases in each group.Indexes such as puncture operation time,anesthesia onset time,pain disappearance time,puncture success rate,anal relaxation,puncture complications,Bromage score of both lower limbs,urinary retention and postoperative pain recovery time were observed and recorded.Results The operation time and postoperative pain recovery time of group U were significantly longer than those of group A,the differences were statistically significant(P<0.05).The onset time of anesthesia and pain disappearance time of group U were significantly shorter than those of group A,the differences were statistically significant(P<0.05).The success rate of puncture in group U was significantly higher than that in group A,the difference was statistically significant(P<0.05).The incidence of puncture bleeding and total complications in group U were lower than those in group A,the differences were statistically significant(P<0.05).There was a significant difference between group U and group A in gradeⅢanesthesia(P<0.05),and there was also a significant difference in anesthetic excellence and failure(P<0.05).There was no significant difference in motor function rating of lower limbs between group U and group A(P>0.05).Conclusion Ultrasound-guided sacral canal nerve block in perianal surgery has the advantages of high puncture success rate,rapid anesthetic effect,rapid pain disappearance,good anal relaxation,fewer puncture complications,and long postoperative analgesia,etc.
作者
万凌峰
徐锃珺
王响林
郭鹏
WAN Lingfeng;XU Zengjun;WANG Xianglin;GUO Peng(The General Hospital of Shaoxing Central Hospital Medical Consortium,Zhejiang 312030,China)
出处
《浙江创伤外科》
2025年第8期1416-1419,共4页
Zhejiang Journal of Traumatic Surgery
基金
绍兴市柯桥区科技局项目(2019KZ14)。
关键词
超声引导
骶管阻滞
肛周手术
Ultrasonic guidance
Sacral canal block
Perianal operation
