摘要
目的探讨超声引导双侧腹横肌平面(TAP)阻滞在腰-硬联合麻醉剖宫产术后的应用效果。方法选取2020年1月至2021年12月接收的60例腰-硬联合麻醉剖宫产产妇作为研究对象,采用电脑盲选法将其分为对照组(n=30,静脉自控镇痛)和研究组(n=30,超声引导双侧TAP阻滞^(+)静脉自控镇痛)。比较两组的镇痛效果。结果术后12、24、48 h,研究组的视觉模拟评分法(VAS)评分低于对照组,差异具有统计学意义(P<0.05)。术后48 h,研究组的皮质醇(Cor)、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、神经元特异性烯醇化酶(NSE)、中枢神经特异蛋白(S100β)水平低于对照组,白细胞分化抗原3阳性(CD3^(+))、白细胞分化抗原4阳性(CD4^(+))、白细胞分化抗原4阳性/白细胞分化抗原8阳性(CD4^(+)/CD8^(+))高于对照组,差异具有统计学意义(P<0.05)。结论超声引导双侧TAP阻滞用于腰-硬联合麻醉剖宫产术后可减轻疼痛及应激反应,对免疫功能的影响小,值得临床应用和推广。
Objective To investigate the application effect of ultrasound-guided bilateral transverse abdominis plane(TAP)block in combined spinal-epidural anesthesia after cesarean section.Methods From January 2020 to December 2021,60 parturients undergoing cesarean section by combined spinal-epidural anesthesia were selected as the research objects.The parturients were divided into control group(n=30,patient-controlled intravenous analgesia)and study group(n=30,ultrasound-guided bilateral TAP block^(+)patient-controlled intravenous analgesia)by computer blind selection method.The analgesic effects of the two groups were compared.Results At 12,24 and 48 h after operation,the Visual Analogue Scale(VAS)score of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).At 48 h after operation,the levels of cortisol(Cor),noradrenaline(NE),angiotensinⅡ(AngⅡ),neuron specific enolase(NSE)and specific protein 100β(S100β)in the study group were lower than those in the control group,the cluster of differentiation 3 positive(CD3^(+)),cluster of differentiation 4 positive(CD4^(+))and cluster of differentiation 4 positive/cluster of differentiation 8 positive(CD4^(+)/CD8^(+))were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided bilateral TAP block in combined spinal-epidural anesthesia after cesarean section can reduce pain and stress response,and has little effect on immune function.It is worthy of clinical application and promotion.
作者
刘忠文
LIU Zhongwen(Jen Ching Memorial Hospital,Suzhou 215300,China)
出处
《临床医学研究与实践》
2023年第15期88-90,98,共4页
Clinical Research and Practice
关键词
剖宫产
腰-硬联合麻醉
超声引导双侧腹横肌平面阻滞
静脉自控镇痛
cesarean section
combined spinal-epidural anesthesia
ultrasound-guided bilateral transverse abdominis planeblock
patient-controlled intravenous analgesia
