[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]
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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()
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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.

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更新日期/Last Update: 1900-01-01