本文選題：腹股溝疝 + 超聲��； 參考：《山東醫(yī)藥》2017年04期

【摘要】：目的探討超聲引導(dǎo)下骼腹股溝—髂腹下神經(jīng)聯(lián)合阻滯(IINB)復(fù)合全麻用于兒童腹股溝疝日間手術(shù)的可行性。方法選擇1~5歲腹股溝疝患兒40例,隨機分為體表定位組和超聲引導(dǎo)組,每組20例。體表定位組采用Schulte-Steinbery法體表定位行IINB,超聲引導(dǎo)組于超聲引導(dǎo)下行IINB。觀察兩組切皮時和結(jié)扎疝囊時體動情況,統(tǒng)計術(shù)中追加丙泊酚的患兒例數(shù);記錄入室即刻、誘導(dǎo)結(jié)束時、切皮完成時、結(jié)扎疝囊即刻、術(shù)畢及蘇醒時HR和平均動脈壓(MAP);記錄術(shù)后麻醉恢復(fù)室(PACU)內(nèi)滯留時間,統(tǒng)計滯留期間出現(xiàn)嘔吐、穿刺點出血或血腫、局麻藥入血或延遲蘇醒的患兒例數(shù),出PACU進行東安大略兒童醫(yī)院疼痛評分(CHEOPS評分)。結(jié)果體表定位組切皮時出現(xiàn)體動12例、術(shù)中追加丙泊酚14例,超聲引導(dǎo)組分別為5、6例,兩組比較P均0.05。超聲引導(dǎo)組切皮完成時、結(jié)扎疝囊即刻、蘇醒時HR均低于體表定位組(P0.05或0.01)。體表定位組、超聲引導(dǎo)組各有2例在PACU內(nèi)滯留期間出現(xiàn)嘔吐,均未出現(xiàn)穿刺點出血或血腫、局麻藥入血及延遲蘇醒等情況。兩組PACU內(nèi)滯留時間比較P0.05;出PACU時體表定位組及超聲引導(dǎo)組CHEOPS評分分別為(7.05±1.47)、(5.30±0.92)分,兩組比較P0.01。結(jié)論超聲引導(dǎo)下IINB復(fù)合全麻用于兒童腹股溝疝日間手術(shù)麻醉效果好,且效為安全。
[Abstract]:Objective to investigate the feasibility of combined iliac groin and inferior iliac nerve block (IINB) combined with general anesthesia guided by ultrasound for daytime operation of inguinal hernia in children. Methods 40 children with inguinal hernia aged 1 to 5 years were randomly divided into body surface localization group and ultrasound guided group, 20 cases in each group. Schulte-Steinbery method was used to locate the body surface in the body surface localization group. To observe the body movement during incision and ligation of hernia sac, and to count the number of children who received propofol during operation, and to record the number of children with hernia sac ligated immediately, at the end of induction, at the end of incision, and at the end of ligation of hernia sac. HR and mean arterial pressure MAPU were recorded at the end of operation and recovery, and the number of children with vomiting, bleeding or hematoma at puncture point, local anesthetic injection or delayed recovery were recorded. PACU was used to evaluate the pain score of Eastern Ontario Children's Hospital (EOPS). Results there were 12 cases of body movement, 14 cases of intraoperative propofol, and 6 cases of ultrasound guided group (P < 0.05). The HR of the ultrasonic guided group was lower than that of the body surface positioning group (P0.05 or 0.01) at the moment of ligation of hernia sac and at the time of awakening. There were 2 cases of vomiting in the PACU group and 2 cases in the ultrasound guided group. There were no bleeding or hematoma at the puncture point, local anesthetic injection and delayed recovery. The CHEOPS scores of body surface localization group and ultrasound guided group were 7.05 鹵1.47 and 5.30 鹵0.92, respectively. Conclusion Ultrasound-guided IINB combined with general anesthesia is effective and safe in the treatment of inguinal hernia in children.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院;
【基金】：基金項目:首都臨床特色應(yīng)用研究與成果推廣(Z161100000516142)
【分類號】：R726.1

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