文章摘要
超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞在老年斜疝手术中的应用
Application of ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profundain elderly hernia surgery
  
DOI：
中文关键词: 超声  旋髂深动脉  神经阻滞  老年  疝气
英文关键词: Ultrasound  Arteriae circumflexa ilium profunda  Nerve block  Elderly  Hernia
基金项目:常熟市卫计委资助性重点项目(csws201501)
作者单位E-mail
濮健峰 215500,江苏省常熟市,扬州大学第五临床医学院  
王梅芳 215500,江苏省常熟市,扬州大学第五临床医学院 2003wmf@163.com 
潘四磊 215500,江苏省常熟市,扬州大学第五临床医学院  
沈志强 215500,江苏省常熟市,扬州大学第五临床医学院  
冯婉琳 215500,江苏省常熟市,扬州大学第五临床医学院  
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中文摘要:
      
目的：探讨超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞在老年斜疝手术中的临床应用效果。
方法：选择择期行斜疝手术的老年患者40例,男33例，女7例，年龄65～90岁, ASA Ⅰ～Ⅲ级, 随机分为两组, 每组20例。T组采用传统髂腹股沟-髂腹下神经阻滞解剖定位
方法：V组采用超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞。记录神经阻滞起效时间,术中、术后6 h VAS评分,麻醉满意度以及尿潴留、误入血管等并发症的发生情况。
结果：V组神经阻滞起效时间明显短于T组[(6.1±1.8)min vs (12.1±2.0)min，P＜0.05];T组术中VAS评分明显高于V组[(4.5±1.1)分 vs (2.1±0.9)分，P＜0.05]。术后6 h两组VAS评分差异无统计学意义;V组麻醉满意度明显高于T组(P＜0.05)。两组均未出现尿潴留, T组有1例误入血管。
结论：超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞能为老年斜疝手术患者提供安全、有效、可靠的麻醉。
英文摘要:
      
Objective: To explore the clinical effect of ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda in elderly hernia surgery.
Methods: Forty ASA Ⅰ-Ⅲ grade patients (33 males and 7 females) of 65 90 years old scheduled for elective hernia surgery were randomly divided into two groups (n=20). In group T, patients received ilioinguinal/iliohypogastric nerve blocks bytraditional anatomical positioning; in group V, patients received ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda. The comparison was made between the two groups in term of onset time of anesthesia, VAS score of intraoperative and postoperative 6 h. Anesthesia satisfaction, incidence of uroschesis, misplacement local anesthetics into blood-vessels were recorded.
Results: The onset time of anesthesia in group V was significantly shorter than that in group T [(6.1±1.8) min vs (12.1±2.0) min, P＜0.05]. The VAS score of intraoperative in group T was significantly higher than that of group V [(4.5±1.1) scores vs (2.1±0.9) scores, P＜0.05]. The anesthesia satisfaction of group V was higher than that of group T (P＜0.05). There was one misplacement local anesthetics into blood-vessels in group T.
Conclusion: ultrasound-guided ilioinguinal/iliohypogastric nerve blocks marked by arteriae circumflexa ilium profunda can provide safe, effective and reliable anesthesia in elderly hernia surgery.
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