摘要
目的通过观察产妇疼痛程度与凝血功能,评价腹横肌平面阻滞(TAPB)联合腹直肌鞘阻滞(RSB)在剖宫产术后镇痛中的作用。方法选择宁波市医疗中心李惠利东部医院2021年1—3月接受剖宫产术的产妇60例,随机数字表法分为两组,每组30例。研究组采用TAPB联合RSB术后镇痛,对照组不作特殊处理。分别于术前即刻(T_(1))、术后8 h(T_(2))、术后24 h(T_(3))、术后48 h(T_(4))检测D-二聚体(DD)水平。T_(2)、T_(3)、T_(4)时,采用视觉模拟疼痛评分(VAS)评价所有产妇静息及运动状态VAS评分。结果T_(1)时,两组产妇DD分别为(1.71±0.35)mg/L、(1.64±0.40)mg/L,T_(2)、T_(3)、T_(4)时分别为(3.18±0.39)mg/L、(3.55±0.43)mg/L,(3.42±0.50)mg/L、(3.77±0.44)mg/L,(2.34±0.40)mg/L、(2.91±0.35)mg/L,均有不同程度升高,且T_(2)、T_(3)、T_(4)时研究组均低于对照组,差异有统计学意义(P<0.05)。静息状态及运动状态下,研究组T_(2)、T_(3)、T_(4)时VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。结论腹横肌平面阻滞联合腹直肌鞘阻滞用于剖宫产术后镇痛,镇痛效果确切,且能在一定程度上缓解产妇血液高凝状态。
Objective To evaluate the role of transversus abdominis plane block(TAPB)combined with rectus sheath block(RSB)in postoperative analgesia of cesarean section by observing the pain level and coagulation function of puerperae.Methods A total of 60 puerperae who underwent cesarean section from January to March 2021 in Ningbo Medical Center-Lihuili Easterrn Hospital were selected and divided into two groups by random number table method,with 30 cases in each group.The study group received TAPB combined with RSB for postoperative analgesia,while no special treatment was given to the control group.The D-dimer(DD)levels were measured immediately before surgery(T_(1)),8 h after surgery(T_(2)),24 h after surgery(T_(3)),and 48 h after surgery(T_(4)),respectively.At T_(2),T_(3),and T_(4),the Visual Analogue Scale(VAS)scores on all puerperae were evaluated during both resting and motor states.Results The DD levels in both groups were(1.71±0.35)mg/L,(1.64±0.40)mg/L at T_(1),and were(3.18±0.39)mg/L,(3.55±0.43)mg/L;(3.42±0.50)mg/L,(3.77±0.44)mg/L and(2.34±0.40)mg/L,(2.91±0.35)mg/L at T_(2),T_(3) and T_(4),respectively,all increased to different degrees,and the levels in the study group were lower than those in the control group at T_(2),T_(3) and T_(4),with statistically significant differences(P<0.05).The VAS scores at T_(2),T_(3) and T_(4) were significantly lower in the study group than in the control group during both resting and motor states,with statistically significant differences(P<0.05).Conclusion The combination of TAPB and RSB has a definite effect on postoperative analgesia of cesarean section and can alleviate blood hypercoagulability of puerperae to a certain extent.
作者
邓曙雨
蔡畅
秦俊杰
郑伟
漆勇
DENG Shuyu;CAI Chang;QIN Junjie;ZHENG Wei;QI Yong(Department of Anesthesiology,Ningbo Medical Center-Lihuili Eastern Hospital,Ningbo315000,China;Department of Obstetrics and Gynecology,Ningbo Medical Center-Lihuili Eastern Hospital,Ningbo315000,China)
出处
《中国现代医生》
2022年第15期118-121,共4页
China Modern Doctor
基金
浙江省宁波市医学科技计划项目(2017A03)。
关键词
剖宫产术
腹横肌平面阻滞
腹直肌鞘阻滞
D-二聚体
血液高凝状态
Cesarean section
Transversus abdominis plane block
Rectus sheath block
D-dimer
Blood hypercoagulability
