[1]林志根,吕 萃,陈忠华,等.局部浸润麻醉与腰硬联合麻醉在经皮肾镜碎石术中的应用疗效对比[J].医学信息,2024,37(13):94-97.[doi:10.3969/j.issn.1006-1959.2024.13.018]
　Comparison of the Efficacy of Local Infiltration Anesthesia and Combined Spinal-epidural Anesthesia in Percutaneous Nephrolithotomy.Comparison of the Efficacy of Local Infiltration Anesthesia and Combined Spinal-epidural Anesthesia in Percutaneous Nephrolithotomy[J].Journal of Medical Information,2024,37(13):94-97.[doi:10.3969/j.issn.1006-1959.2024.13.018]
点击复制

局部浸润麻醉与腰硬联合麻醉在经皮肾镜碎石术中的应用疗效对比()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年13期
页码:
94-97
栏目:
论著
出版日期:
2024-07-01

文章信息/Info

Title:
Comparison of the Efficacy of Local Infiltration Anesthesia and Combined Spinal-epidural Anesthesia in Percutaneous Nephrolithotomy
文章编号:
1006-1959（2024）13-0094-04
作者:
林志根; 吕 萃; 陈忠华; 等
（泰和县人民医院神经泌尿外科，江西 泰和 343713）
Author(s):
Comparison of the Efficacy of Local Infiltration Anesthesia and Combined Spinal-epidural Anesthesia in Percutaneous Nephrolithotomy
(Department of Neurology and Urology,Taihe County People’s Hospital,Taihe 343713,Jiangxi,China)
关键词:
经皮肾镜碎石术; 局部浸润麻醉; 腰硬联合麻醉; 血流动力学
Keywords:
Percutaneousnephrolithotripsy; Local infiltration anesthesia; Combined spinal-epidural anesthesia; Hemodynamics
分类号:
R614
DOI:
10.3969/j.issn.1006-1959.2024.13.018
文献标志码:
A
摘要:
目的 对比局部浸润麻醉与腰硬联合麻醉在经皮肾镜碎石术（PCNL）中的应用效果。方法 以2020年5月-2023年5月泰和县人民医院拟行PCNL治疗的50例患者为研究对象，采用随机数字表法分为局部浸润组（25例）与腰硬联合组（25例），局部浸润组采用局部浸润麻醉，腰硬联合组则选择腰硬联合麻醉，比较两组麻醉前（T0）、置入输尿管导管时（T1）、建立经皮肾镜碎石通道时（T2）的疼痛程度[视觉模拟疼痛评分（VAS）]，分析两组T0、T1、T2及手术结束时（T3）的血流动力学水平[平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2）]，记录两组麻醉不良反应与麻醉满意度。结果 腰硬联合组T1、T2时VAS评分均低于局部浸润组（P＜0.05）。局部浸润组T1、T2时 MAP、HR、SpO2低于T0（P＜0.05），腰硬联合组T0、T1、T2、T3时MAP、HR、SpO2比较，差异无统计学意义（P＞0.05）；两组T1、T2时MAP、HR、SpO2比较，差异有统计学意义（P＜0.05）。腰硬联合组麻醉不良反应发生率小于局部浸润组（P＜0.05）。腰硬联合组麻醉满意度高于局部浸润组（P＜0.05）。结论 局部浸润麻醉与腰硬联合麻醉在PCNL治疗中均具有良好的麻醉作用，但后者镇痛作用更为理想，可保持患者血流动力学稳定，且不良反应少、麻醉满意度高。
Abstract:
Objective To compare the application effect of local infiltration anesthesia and combined spinal-epidural anesthesia in percutaneous nephrolithotomy (PCNL).Methods A total of 50 patients who underwent PCNL in Taihe County People’s Hospital from May 2020 to May 2023 were randomly divided into local infiltration group (25 patients) and combined spinal-epidural anesthesia group (25 patients). The local infiltration group was treated with local infiltration anesthesia, while the combined spinal-epidural anesthesia group was treated with combined spinal-epidural anesthesia. The pain degree [Visual Analogue Scale(VAS)score] before anesthesia (T0), at the time of ureteral catheter placement (T1) and at the time of establishment of percutaneous nephrolithotripsy channel (T2) were compared between the two groups. The hemodynamic levels [mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2)] of the two groups at T0, T1, T2 and the end of operation (T3) were analyzed, and the adverse reactions of anesthesia and anesthesia satisfaction of the two groups were recorded.Results The VAS score at T1 and T2 in the combined spinal-epidural anesthesia group were lower than that in the local infiltration group (P<0.05). MAP, HR and SpO2 at T1 and T2 in the local infiltration group were lower than those at T0 (P<0.05). There was no significant difference in MAP, HR and SpO2 at T0, T1, T2 and T3 in the combined spinal-epidural anesthesia group (P>0.05). There were significant differences in MAP, HR and SpO2 between the two groups at T1 and T2 (P<0.05). The incidence of adverse reactions in thecombined spinal-epidural anesthesia group was lower than that in the local infiltration group (P<0.05). The anesthesia satisfaction of the combined spinal-epidural anesthesia group was higher than that of the local infiltration group (P<0.05).Conclusion Local infiltration anesthesia and combined spinal-epidural anesthesia have good anesthetic effects in the treatment of PCNL, but the analgesic effect of the latter is more ideal, which can maintain the hemodynamic stability of patients, with less adverse reactions and high anesthesia satisfaction.

参考文献/References:

[1]王锦平,张敏,何静.腰方肌阻滞复合全身麻醉对老年经皮肾镜取石术患者的影响[J].实用临床医药杂志,2023,27(6):72-75,80.[2]金侃,汪东学,张跃东,等.腰方肌阻滞联合全身麻醉在经皮肾镜碎石术中的应用效果[J].局解手术学杂志,2022,31(12):1068-1071.[3]张锦曦,刘雯雯,祝卿,等.小剂量低浓度左旋布比卡因腰硬联合麻醉用于经皮肾镜碎石取石术的临床观察[J].检验医学与临床,2022,19(17):2404-2406.[4]崔书平,薄瑞娟,曾博文,等.局麻下微创经皮肾镜取石术治疗脊柱畸形患者上尿路结石[J].中国现代手术学杂志,2022,26(3):216-221.[5]高华廷,王磊,朱家红,等.局麻经皮肾镜碎石取石术临床应用探讨[J].国际泌尿系统杂志,2019,39(6):1050-1052.[6]张敬莹,姜明哲,李亮,等.喉罩通气全身麻醉与腰硬联合麻醉对输尿管镜钬激光碎石术患者麻醉效果、血流动力学和应激反应的影响[J].现代生物医学进展,2022,22(5):975-979,984.[7]余思君.腰硬联合麻醉和硬膜外麻醉在老年患者输尿管镜下钬激光碎石术中的应用[J].中国全科医学,2021,24(S1):74-76.[8]江钦玉,胡正权,周海,等.椎旁神经阻滞联合全麻与全麻对经皮肾镜取石术患者早期康复的影响比较[J].徐州医科大学学报,2020,40(10):745-749.[9]黎衍敏,伍耿青.局麻与全麻微创经皮肾镜取石术治疗老年肾结石的对比研究[J].中国医药导报,2020,17(22):94-97.[10]郑亮亮,匡仁锐,邓君,等.刺激性利尿局麻微创经皮肾镜取石术在上尿路结石中的应用[J].微创泌尿外科杂志,2020,9(4):240-244.[11]孔祥辉,孙朝晖,黄晓军.局部麻醉联合术前镇静下经皮肾镜取石术的疗效观察[J].浙江医学,2020,42(7):730-731,734.[12]陈晓炜,许学兵,李玄英,等.超声引导胸椎旁阻滞对经皮肾镜术后镇痛的影响[J].中国中西医结合外科杂志,2019,25(1):40-45.[13]甘伟,许红霞,李云飞,等.局部浸润麻醉下行经皮肾镜取石术临床效果分析[J].中国现代手术学杂志,2018,22(5):385-387.[14]程龙,周雁,许莉,等.超声引导下胸椎旁阻滞联合蛛网膜下隙阻滞在经皮肾镜碎石术中的应用[J].中国临床医生杂志,2018,46(7):836-838.[15]靳永强,黄焕森,赵年章,等.超声引导椎旁神经阻滞对PCNL手术患者伤害应激反应的影响[J].广东医学,2018,39(11):1701-1704.[16]周先科,陈君,唐媛,等.超声引导下椎旁神经阻滞复合右美托咪定麻醉在经皮肾镜碎石取石术中的应用[J].微创泌尿外科杂志,2018,7(3):177-180.[17]王浩,李健,王奎海.超声引导局部麻醉经皮肾镜碎石术治疗上尿路结石56例[J].海军医学杂志,2018,39(2):183-185.[18]周勤,魏新川.不同浓度罗哌卡因腰麻-硬膜外联合麻醉对经皮肾镜碎石术患者术中血流动力学的影响研究[J].四川医学,2018,39(3):324-327.[19]杨文庆,李程,胡俊.腰麻联合硬膜外麻醉对经皮肾镜钬激光碎石术患者的麻醉效果比较[J].重庆医学,2018,47(A01):248-250.[20]顾杰,李杜渐.超声引导下椎旁神经阻滞麻醉在经皮肾镜碎石术中的应用[J].临床外科杂志,2022,30(6):552-555.[21]Mohamed MHAT,Al-Hamri S,Askar A,et al.Spinal versus general anesthesia for retrograde intrarenal surgery: A prospective double-blinded randomized-controlled trial[J].European Urology Supplements,2018,17(2):e1393.

相似文献/References:

[1]刘小良,廖鑫鑫,黄 鹏,等.经皮肾镜碎石术术中肾盂内压对预测术后感染的影响[J].医学信息,2019,32(24):66.[doi:10.3969/j.issn.1006-1959.2019.24.021]
　LIU Xiao-liang,LIAO Xin-xin,HUANG Peng,et al.Effect of Intrapelvic Pressure during Percutaneous Nephrolithotomy on Predicting Postoperative Infection[J].Journal of Medical Information,2019,32(13):66.[doi:10.3969/j.issn.1006-1959.2019.24.021]
[2]刘 静,王 鹏,王云涛,等.剖宫产患者麻醉方法的研究[J].医学信息,2022,35(14):176.[doi:10.3969/j.issn.1006-1959.2022.14.046]
　LIU Jing,WANG Peng,WANG Yun-tao,et al.Study on Anesthesia Method of Cesarean Section Patients[J].Journal of Medical Information,2022,35(13):176.[doi:10.3969/j.issn.1006-1959.2022.14.046]

更新日期/Last Update: 1900-01-01