|
| 肋缘下前路腰方肌阻滞对腹腔镜胆囊切除术患者术后恢复质量的影响 |
| Effect of subcostal anterior quadrate lumborum block on quality of postoperative recovery in patients undergoing laparoscopic cholecystectomy |
| |
| DOI：10.12089/jca.2026.03.006 |
| 中文关键词: 肋缘下前路腰方肌阻滞 氟比洛芬酯 腹腔镜胆囊切除术 镇痛 应激反应 快速康复 |
| 英文关键词: Subcostal anterior quadratus lumborum block Flurbinofen axetil Laparoscopic cholecystectomy Analgesia Stress response Enhanced recovery |
| 基金项目:蚌埠市科技创新项目（20230125） |
|
| 摘要点击次数: 831 |
| 全文下载次数: 224 |
| 中文摘要: |
目的： 探讨肋缘下前路腰方肌阻滞（SA-QLB）对腹腔镜胆囊切除术（LC）患者术后恢复质量的影响。
方法： 选择2022年2月至2025年4月接受LC治疗的患者，年龄18～79岁，BMI≤35 kg/m2，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者分为两组：对照组（C组）和SA-QLB组（Q组）。两组于麻醉诱导时静脉注射氟比洛芬酯1 mg/kg。Q组麻醉诱导完成后行SA-QLB，注射0.375%罗哌卡因20 ml。主要指标为术后24 h 15项恢复质量（QoR-15）评分。次要指标包括术前24 h QoR-15评分，入室时、气管插管后、建立气腹时、气腹5 min时、术毕即刻的HR和MAP，术后2、6、12、24 h静息时VAS疼痛评分，术中瑞芬太尼、舒芬太尼用量，镇痛泵有效按压次数、镇痛泵总按压次数，补救镇痛率，肠道功能恢复时间和术后首次下床活动时间。不良反应包括术后皮肤瘙痒、头晕、恶心、呕吐和嗜睡。
结果： 共纳入患者70例，每组35例。与C组比较，Q组术后24 h QoR-15评分身体舒适度、自理能力、情绪状态、疼痛和总分明显升高，建立气腹时、气腹5 min时HR明显减慢、MAP明显降低，术后2、6、12 h VAS疼痛评分明显降低，术中舒芬太尼、瑞芬太尼用量、镇痛泵总按压次数和有效按压次数明显减少，补救镇痛率明显降低，肠道恢复时间和术后首次下床活动时间明显缩短（P＜0.05）。
结论： 在LC患者中，SA-QLB能为患者提供更完善的术后镇痛，有效提高术后恢复质量，促进患者康复。 |
| 英文摘要: |
Objective: Investigating the effect of subcostal anterior quadratus lumborum block (SA-QLB) on the quality of postoperative recovery in patients undergoing laparoscopic cholecystectomy (LC).
Methods: Patients who underwent LC between February 2022 and April 2025 were selected, aged 18-79 years, BMI ≤ 35 kg/m2, ASA physical status Ⅰ or Ⅱ. Patients were divided into two groups using a random number table: the control group (group C) and the SA-QLB group (group Q). Patients received an intravenous injection of flurbiprofen axetil 1 mg/kg at anesthesia induction. After completing anesthesia induction, SA-QLB was performed using 0.375% ropivacaine 20 ml injection in group Q. The primary outcome was 15-item quality of recovery scale (QoR-15) scores at 24 hours postoperatively. Secondary outcomes included QoR-15 scores at 24 hours preoperectively, HR and MAP upon entering the operating room, after tracheal intubation, at pneumoperitoneum establishment, 5 minutes after pneumoperitoneum, and immediately after surgery, VAS pain scores at rest at 2, 6, 12, and 24 hours postoperatively, the intraoperative consumption of remifentanil and sufentanil, the total number of analgesic pump presses, the incidence of rescue analgesia, time to bowel function recovery, first time to ambulation. Adverse reactions included postoperative skin itching, dizziness, nausea, vomiting, and drowsiness.
Results: Seventy patients were enrolled, 35 patients in each group. Compared with group C, the scores in physical comfort, self-care ability, emotional state, pain, and total score on the QoR-15 at 24 hours postoperatively were significantly increased, HR and MAP at pneumoperitoneum establishment and 5 minutes after pneumoperitoneum were significantly decreased, VAS pain scores at rest at 2, 6, and 12 hours postoperatively were significantly decreased, consumption of sufentanil and remifentanil, total number of analgesic pump presses, and number of effective presses were significantly reduced, the incidence of rescue analgesia was significantly decreased, time to bowel function recovery and time to ambulation were significantly shortened in group Q (P < 0.05).
Conclusion: In patients undergoing LC, SA-QLB can provide more comprehensive postoperative analgesia, alleviate surgical stress response, effectively improve the quality of postoperative recovery, and promote patient rehabilitation. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
