超声引导下ESP与TAP对结直肠癌根治术患者治疗效果的比较

doi:10.7517/issn.1674-0475.220704

摘要/Abstract

摘要： 本研究的目的是对比超声引导下竖脊肌平面阻滞(ESP)与超声引导下腹横肌平面阻滞(TAP)对结直肠癌根治术患者术后镇痛效果。选取进行结直肠癌根治术的120例患者作为研究对象,按照随机数字表法分为对照组和研究组,各60例,对照组患者进行超声引导下TAP,研究组患者进行超声引导下ESP,检测两组心率、平均动脉压、视觉模拟评分法(VAS)评分、Ramsay镇静评分、应激反应问卷(SRQ)评分、用药剂量、苏醒指标检测、并发症反应。与T₀、T₁、T₂相比,T₃时两组患者心率、平均动脉压水平均升高,但研究组低于对照组(P＜0.05)。与对照组相比,研究组患者术后2h、4h、8h、12hVAS评分较低,Ramsay镇静评分较高(P＜0.05)。与术前相比,术后48h两组患者情绪反应、躯体反应、行为反应评分降低,且研究组评分低于对照组(P＜0.05)。与对照组相比,研究组患者瑞芬太尼、丙泊酚用量较少,苏醒时间、清醒时间、气管拔管时间更短,且并发症发生率较低(P＜0.05)。相对于超声引导下TAP,ESP术后镇痛效果较好,可使并发症发生率降低,加快患者术后恢复。

关键词: 结直肠癌, 超声引导, 竖脊肌平面阻滞, 腹横肌平面阻滞, 镇痛

Abstract: The objective of this study was to compare the postoperative analgesic effects of ultrasound-guided erector spinae plane block (ESP) and ultrasound-guided transverse abdominis plane block (TAP) on patients undergoing radical resection of colorectal cancer. A total of 120 patients who underwent radical resection of colorectal cancer were selected as the research objects, and divided into the control group and the study group according to the random number table method with 60 cases in each group. The control group underwent ultrasound-guided TAP, the study group underwent ultrasound-guided ESP, and the heart rate, mean arterial pressure, visual analogue scale (VAS) score, Ramsay sedation score, stress-reaction questionnaire (SRQ) score, drug dose, recovery index detection, and complication response were detected in the two groups. Compared with T₀,T₁, and T₂, the heart rate and mean arterial pressure of the two groups increased at T₃, but the study group was lower than the control group (P<0.05). Compared with the control group, the VAS scores of the patients in the study group were lower at 2 h, 4 h, 8 h, and 12 h after the operation, and the Ramsay sedation score was higher (P<0.05). Compared with preoperative, the scores of emotional response, physical response and behavioral response in the two groups decreased at 48 h after surgery, and the scores in the study group were lower than those in the control group (P<0.05). Compared with the control group, the patients in the study group had less dosage of remifentanil and propofol, the recovery time, wake time and tracheal extubation time were shorter, and the incidence of complications was lower (P<0.05). Compared with ultrasound-guided TAP, ESP has better postoperative analgesia, which can reduce the incidence of complications and speed up the postoperative recovery of patients.

Key words: colorectal cancer, ultrasound guidance, erector spinae plane block, transverse abdominis plane block, analgesia

兰浩, 詹锐, 汪越, 张晓琴. 超声引导下ESP与TAP对结直肠癌根治术患者治疗效果的比较[J]. 影像科学与光化学, 2022, 40(6): 1455-1459.

LAN Hao, ZHAN Rui, WANG Yue, ZHANG Xiaoqin. Comparison of Ultrasound-guided ESP and TAP in the Treatment Effect of Colorectal Cancer Patients Undergoing Radical Resection[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1455-1459.

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