【摘要】：目的：通過對(duì)比研究?jī)煞N不同的麻醉方式下行大隱靜脈剝脫術(shù)的效果,探討超聲引導(dǎo)下局部腫脹麻醉行大隱靜脈剝脫術(shù)的可行性。觀察此方式的臨床治療效果,并總結(jié)出此方式治療大隱靜脈曲張的優(yōu)缺點(diǎn),進(jìn)一步發(fā)現(xiàn)超聲引導(dǎo)下局部腫脹麻醉行大隱靜脈剝脫術(shù)的不足,補(bǔ)充完善此項(xiàng)技術(shù)的相關(guān)研究。方法：1、選擇我院住院符合診斷標(biāo)準(zhǔn)、納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)的大隱靜脈曲張60例患者。采用完全隨機(jī)分組法將其分為實(shí)驗(yàn)組(超聲引導(dǎo)下局部腫脹麻醉下行大隱靜脈高位結(jié)扎+內(nèi)剝脫+微靜脈切除術(shù))及對(duì)照組(硬膜外麻醉下行大隱靜脈高位結(jié)扎+內(nèi)剝脫+微靜脈切除術(shù)),二組各30例患者進(jìn)行治療,最后根據(jù)手術(shù)時(shí)間,術(shù)中剝脫大隱靜脈主干時(shí)的血壓、心率,術(shù)后VAS疼痛分?jǐn)?shù),術(shù)后臥床活動(dòng)時(shí)間,術(shù)后并發(fā)癥以及經(jīng)濟(jì)效益等判定兩種不同麻醉方式的效果。2、借助統(tǒng)計(jì)學(xué)方法,比較二組的效果差別,從而得出超聲引導(dǎo)下局部腫脹麻醉下行大隱靜脈剝脫術(shù)的可行性,通過與硬膜外麻醉行大隱靜脈剝脫術(shù)的效果比較,從而進(jìn)一步完善此麻醉方式的相關(guān)研究。結(jié)果：1、本次研究共收集60例患者(83條肢體),實(shí)驗(yàn)組30例(44條肢體),對(duì)照組30例(39條肢體),兩組患者在性別、年齡、分級(jí)構(gòu)成上差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組數(shù)據(jù)具有可比性。2、超聲引導(dǎo)下局部腫脹麻醉行大隱靜脈剝脫術(shù)與硬膜外麻醉行大隱靜脈剝脫術(shù)在手術(shù)時(shí)間、惡心嘔吐上差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3、實(shí)驗(yàn)組在術(shù)后VAS疼痛分?jǐn)?shù)、術(shù)后臥床活動(dòng)時(shí)間、術(shù)后尿潴留、術(shù)后下肢深靜脈血栓、術(shù)后住院時(shí)間以及住院費(fèi)用上低于對(duì)照組,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4、對(duì)照組在術(shù)中剝脫大隱靜脈主干時(shí)的血壓、心率波動(dòng)上低于實(shí)驗(yàn)組,其差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：超聲引導(dǎo)下局部腫脹麻醉與硬膜外麻醉用于大隱靜脈主干剝脫上均具有簡(jiǎn)單、安全、療效好的特點(diǎn)。超聲引導(dǎo)下局部腫脹麻醉行大隱靜脈剝脫術(shù)術(shù)后能夠快速康復(fù),能有效避免麻醉術(shù)后并發(fā)癥及深靜脈血栓的形成,減輕術(shù)后疼痛,同時(shí)可降低患者住院費(fèi)用,減輕患者經(jīng)濟(jì)壓力。因此,該麻醉方式在大隱靜脈主干處理上有較好的應(yīng)用前景。
[Abstract]:Objective: to study the effect of two different anaesthesia methods on saphenous vein exfoliation and to explore the feasibility of local swelling anesthesia under ultrasound guidance. The clinical effect of this method was observed and the advantages and disadvantages of the treatment of varicose great saphenous vein were summarized. Methods: 1. 60 patients with varicose great saphenous vein were selected. It was divided into experimental group (high ligation of great saphenous vein under ultrasound-guided high ligation of saphenous vein) and control group (high ligation of great saphenous vein under epidural anesthesia). Exfoliation of venipuncture), According to the time of operation, the blood pressure, heart rate, VAS pain score, the time of bed rest after operation, the heart rate, the time of operation, and the time of bed rest, according to the time of operation, the heart rate, the pain score of VAS and the time of bed rest after operation. Postoperative complications and economic benefits were used to determine the effects of two different anesthetic methods. 2. By means of statistical method, the difference between the two groups was compared, and the feasibility of local swelled anesthesia under ultrasound guidance was obtained in the removal of great saphenous vein. By comparing with epidural anesthesia the effect of great saphenous vein exfoliation was compared to further improve the related study of this anesthesia. Results: 1. There were 60 patients (83 limbs) in this study, 30 in experimental group (44 limbs) and 30 in control group (39 limbs). There was no significant difference in sex, age and grade composition between the two groups (P0.05). The data of the two groups were comparable. (2) there was no significant difference in the operation time, nausea and vomiting between the local swelling anesthesia and epidural anesthesia under the guidance of ultrasound (P0.05), and there was no significant difference between the two groups in the time of operation, nausea and vomiting (P0.05), and there was no significant difference between the two groups in the time of operation (P0.05). The scores of postoperative VAS pain, postoperative bed rest time, postoperative urinary retention, postoperative deep vein thrombosis, postoperative hospitalization time and hospitalization cost in the experimental group were significantly lower than those in the control group (P0.05). The blood pressure and heart rate fluctuation of the control group were lower than that of the experimental group during the operation of stripping the main trunk of the great saphenous vein. The difference was statistically significant (P0.05). Conclusion: Ultrasound-guided local swelling anesthesia and epidural anesthesia are simple, safe and effective for stripping the main trunk of saphenous vein. Ultrasound-guided local swelling anesthesia with great saphenous vein exfoliation can recover quickly, can effectively avoid complications after anesthesia and the formation of deep venous thrombosis, alleviate postoperative pain, and reduce the cost of hospitalization. Reduce the patient's economic pressure. Therefore, the anesthesia has a good prospect in the treatment of saphenous vein trunk.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R654.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前8條

1 陳濤;;局部腫脹麻醉聯(lián)合肋間神經(jīng)阻滯麻醉在男性乳房肥大癥手術(shù)中的應(yīng)用[J];中國(guó)廠礦醫(yī)學(xué);2008年02期

2 羅瑤;黃曉波;陳江山;;容量治療對(duì)腹部局部腫脹麻醉抽脂術(shù)循環(huán)的影響[J];實(shí)用醫(yī)院臨床雜志;2007年02期

3 陶宏煒,宣慶元;局部腫脹麻醉隆乳術(shù)[J];實(shí)用美容整形外科雜志;2003年02期

4 何平;王亞非;鄧蒞霏;紀(jì)剛;;局部腫脹麻醉在乳腺手術(shù)中的應(yīng)用[J];贛南醫(yī)學(xué)院學(xué)報(bào);2009年01期

5 馮傳波,張立憲,羅錦輝,陳林峰,時(shí)安平;門診局麻下抽脂89例報(bào)告[J];實(shí)用美容整形外科雜志;1999年03期

6 李江,魯開化,艾玉峰,郭樹忠,韓巖;持續(xù)組織擴(kuò)張手術(shù)方法及擴(kuò)張期臨床管理[J];第四軍醫(yī)大學(xué)學(xué)報(bào);1999年11期

7 左成忻;黃進(jìn)華;陳靜;魯建云;向亞萍;;局部腫脹麻醉高頻電治療腋臭60例臨床療效分析[J];實(shí)用預(yù)防醫(yī)學(xué);2005年06期

8 ;[J];;年期

相關(guān)會(huì)議論文 前2條

1 韓斐;;Nd:YAG激光溶脂手術(shù)的配合體會(huì)[A];中華醫(yī)學(xué)會(huì)整形外科學(xué)分會(huì)第十一次全國(guó)會(huì)議、中國(guó)人民解放軍整形外科學(xué)專業(yè)委員會(huì)學(xué)術(shù)交流會(huì)、中國(guó)中西醫(yī)結(jié)合學(xué)會(huì)醫(yī)學(xué)美容專業(yè)委員會(huì)全國(guó)會(huì)議論文集[C];2011年

2 韓斐;;Nd:YAG激光溶脂手術(shù)的配合體會(huì)[A];2011年浙江省整形美容學(xué)術(shù)會(huì)議論文匯編[C];2011年

相關(guān)碩士學(xué)位論文 前1條

1 周思聰;超聲引導(dǎo)下局部腫脹麻醉與硬膜外麻醉行大隱靜脈剝脫術(shù)的臨床對(duì)比研究[D];福建中醫(yī)藥大學(xué);2016年

，

本文編號(hào)：2398653