[1]邵元媛,王宏娟,陈　薇,等.超声引导下腰方肌筋膜平面阻滞与腹横肌筋膜平面阻滞用于剖宫产术后疼痛的比较[J].介入放射学杂志,2023,32(02):153-157.
　SHAO Yuanyuan,WANG Hongjuan,CHEN Wei,et al.Ultrasound-guided quadratus lumborum fascial plane block versus transverse abdominis fascial plane block for post-cesarean section pain: a comparison study[J].journal interventional radiology,2023,32(02):153-157.
点击复制

超声引导下腰方肌筋膜平面阻滞与腹横肌筋膜平面阻滞用于剖宫产术后疼痛的比较()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年02
页码:
153-157
栏目:
临床研究
出版日期:
2023-03-03

文章信息/Info

Title:
Ultrasound-guided quadratus lumborum fascial plane block versus transverse abdominis fascial plane block for post-cesarean section pain: a comparison study
作者:
邵元媛; 　王宏娟; 　陈　薇; 　朱秀娟; 　丰　亮
Author(s):
SHAO Yuanyuan;  WANG Hongjuan;  CHEN Wei;  ZHU Xiujuan;  FENG Liang.
Department of Anesthesiology, Nantong Municipal Second People’s Hospital, Nantong, Jiangsu Province 226600, China
关键词:
【关键词】 超声引导; 剖宫产; 疼痛; 腰方肌筋膜平面阻滞; 腹横肌筋膜平面阻滞
文献标志码:
A
摘要:
【摘要】　目的　比较超声引导下腰方肌筋膜平面阻滞（QLB）与腹横肌筋膜平面阻滞（TAP）用于剖宫产术后的镇痛疗效。方法　纳入2018年4月至2020年4月在蛛网膜下腔阻滞下行剖宫产的患者76例，随机分为QLB组38例，TAP组38例。两组患者术后均给予静脉吗啡自控镇痛泵。观察术后48 h内各时间段的疼痛VAS评分、吗啡使用剂量以及相关并发症的发生率。结果　术后12 h，QLB组吗啡消耗量为（6.08±2.76）mg，TAP组为（7.97±3.22）mg；术后24 h，QLB组吗啡消耗量为（6.89±5.01）mg，TAP组为（14.12±6.76）mg；术后48 h，QLB组吗啡消耗量为（9.12±8.22）mg，TAP组为（18.07±9.86）mg，差异均有统计学意义（P=0.039、0.013、0.022）。术后24 h和48 h，TAP组患者的疼痛VAS评分高于QLB组（P＜0.05），术后12 h内两组患者的疼痛VAS评分差异无统计学意义（P＞0.05）；TAP组出现眩晕、恶性呕吐的例数高于QLB组（P＜0.05）。结论　对于剖宫产术后镇痛，超声引导下QLB在吗啡使用剂量、疼痛缓解以及并发症等方面优于TAP。

参考文献/References:

［1］ Creze M, Soubeyrand M, Nyangoh TK, et al. Organization of the fascia and aponeurosis in the lumbar paraspinal compartment［J］. Surg Radiol Anat, 2018, 40: 1231-1242.
［2］ Fan C, Fede C, Gaudreault N, et al. Anatomical and functional relationships between external abdominal oblique muscle and posterior layer of thoracolumbar fascia［J］. Clin Anat, 2018, 31: 1092-1098.
［3］　Blanco R. Tap block under ultrasound guidance: the description of a "no pops"technique: 271［J］. Reg Anesth Pain Med, 2007, 32: S130.
［4］　单玉兰，周晓林，徐小青. 超声引导髂筋膜阻滞与股神经阻滞治疗全膝关节置换后疼痛的疗效比较［J］. 介入放射学杂志，2020，29：1244-1248．
［5］ Rao KV, Ludbrook G, Van Wijk RM, et al. Comparison of ultrasound-guided transmuscular quadratus lumborum block catheter technique with surgical pre-peritoneal catheter for postoperative analgesia in abdominal surgery: a randomised controlled trial［J］. Anaesthesia, 2019, 74: 1381-1388.
［6］　刘　鑫，杨小燕. 右美托咪定术前给药结合腹横肌平面阻滞在小儿腹腔镜手术中的效果观察［J］. 腹腔镜外科杂志，2020，25：788-791．
［7］　周　新，王胜斌. 切口局麻药浸润和超声引导下腹横肌平面阻滞对腹腔镜胆囊切除患者术后恢复的影响［J］. 肝胆外科杂志，2020，28：297-299．
［8］ Mieszkowski MM, Mayzner-Zawadzka E, Tuyakov B, et al. Evaluation of the effectiveness of the quadratus lumborum block typeⅠusing ropivacaine in postoperative analgesia after a cesarean section: a controlled clinical study［J］. Ginekol Pol, 2018, 89: 89-96.
［9］　Stecco C, Sfriso MM, Porzionato A, et al. Microscopic anatomy of the visceral fasciae［J］. J Anat, 2017, 231: 121-128.
［10］ Mitchell J, Schmidt R . Cardiovascular reflex control by afferent fibers from skeletal muscle receptors. in: comprehensive physiology［J］. Compr Physiol,2010,1: 1-36
［11］ Harms J, Stone AJ, Kaufman MP. Peripheral μ-opioid receptors attenuate the responses of group Ⅲ and Ⅳ afferents to contraction in rats with simulated peripheral artery disease［J］. J Neurophysiol, 2018, 119: 2052-2058.
［12］ Sheyn D, Ben-David S, Tawackoli W, et al. Human iPSCs can be differentiated into notochordal cells that reduce intervertebral disc degeneration in a porcine model［J］. Theranostics, 2019, 9: 7506-7524.
［13］ Tesarz J, Hoheisel U, Wiedenhofer B, et al. Sensory innervation of the thoracolumbar fascia in rats and humans［J］. Neuroscience, 2011, 194: 302-308.
［14］ Staubesand J, Baumbach KU, Li Y . On the ultrastructure of the crural fascia in patients with chronic venous insufficiency and varicose leg ulcers ［J］. Phlebologie,1997,50:105-113.
［15］ Aditianingsih D, Pryambodho, Anasy N, et al. A randomized controlled trial on analgesic effect of repeated quadratus lumborum block versus continuous epidural analgesia following laparoscopic nephrectomy［J］. BMC Anesthesiol, 2019, 19: 221.
［16］ Chen Y, Shi K, Xia Y, et al. Sensory assessment and regression rate of bilateral oblique subcostal transversus abdominis plane block in volunteers［J］. Reg Anesth Pain Med, 2018, 43: 174-179.

相似文献/References:

[1]胡 鹏,李玉伟,李云辉,等.剖宫产后出血原因分析及介入治疗的价值[J].介入放射学杂志,2011,(08):613.
　HU Peng,LI Yu-wei,LI Yun-hui,et al.The analysis of the causes of uterine bleeding occurred after cesarean section and the evaluation of interventional therapy for bleeding[J].journal interventional radiology,2011,(02):613.
[2]魏 炜,艾 红,阮郦韬.超声引导下乳腺小微病灶导丝定位的临床应用[J].介入放射学杂志,2015,(07):629.
　WEI Wei,AI Hong,RUAN Li- tao.Clinical application of preoperative ultrasound- guided guide- wire localization in diagnosing tiny breast lesions[J].journal interventional radiology,2015,(02):629.
[3]韦红霞,束晓霞,李斌义.聚桂醇在单纯性肾囊肿硬化治疗中的应用价值[J].介入放射学杂志,2016,(12):1094.
　WEI Hong- xia,SHU Xiao- xia,LI Bin- yi.The application value of lauromacrogol in sclerotherapy of simple renal cysts[J].journal interventional radiology,2016,(02):1094.
[4]董 亮,周 青,纪永利,等.超声与CT经皮穿刺在超声可视性胸部病变定性诊断中的对比研究[J].介入放射学杂志,2017,(08):718.
　DONG Liang,ZHOU Qing,JI Yongli,et al.Ultrasound- guided versus CT- guided percutaneous biopsy for the qualitative diagnosis of ultrasonic- visual chest lesions： a comparison study[J].journal interventional radiology,2017,(02):718.
[5]单玉兰,周晓林,朱小兰,等.超声引导下前锯肌阻滞与胸椎硬膜外阻滞治疗急性胸廓切开术后疼痛的疗效比较[J].介入放射学杂志,2020,29(05):472.
　SHAN Yulan,ZHOU Xiaolin,ZHU Xiaolan,et al.Ultrasound-guided serratus anterior plane block versus thoracic epidural block in the treatment of acute pain after thoracotomy[J].journal interventional radiology,2020,29(02):472.
[6]吴中俭,高明杰,谷涌泉,等.超声引导下定向斑块旋切联合药物涂层球囊治疗股浅动脉重度狭窄1例[J].介入放射学杂志,2020,29(07):736.
　WU Zhongjian,GAO Mingjie,GU Yongquan,et al.Successful treatment of severe stenosis of superficial femoral artery by using ultrasound-guided direct rotational atherectomy combined with drug-coating balloon dilatation： report of one case[J].journal interventional radiology,2020,29(02):736.
[7]李 晓,唐栋梁,王 洁,等.超声引导竖脊肌间隙阻滞与胸椎椎旁神经阻滞治疗乳腺癌术后急性疼痛疗效观察 [J].介入放射学杂志,2020,29(08):777.
　LI Xiao,TANG Dongliang,WANG Jie,et al.Ultrasound-guided erector spinae block and thoracic paravertebral block for the treatment of acute pain after surgery of breast cancer[J].journal interventional radiology,2020,29(02):777.
[8]陶小红,孟继红,潘亚娟,等.超声引导股神经阻滞与收肌管阻滞用于全膝关节置换术后镇痛的跌倒风险[J].介入放射学杂志,2021,30(01):34.
　TAO Xiaohong,MENG Jihong,PAN Yajuan,et al.Ultrasound-guided femoral nerve block versus adductor canal block for postoperative analgesia after total knee arthroplasty： comparison of the falling risk[J].journal interventional radiology,2021,30(02):34.
[9]王 懿,陈 沛,万光明.中长期静脉通路互联网平台的构建与应用[J].介入放射学杂志,2021,30(07):730.
　WANG Yi,CHEN Pei,WAN Guangming..Establishment and application of internet platform used for mid-to-long-term management of venous access[J].journal interventional radiology,2021,30(02):730.
[10]吉冬梅,徐小青,史传岗.超声引导膝关节腔注射对患者满意度、关节功能和生活质量的影响[J].介入放射学杂志,2021,30(10):1040.
　JI Dongmei,XU Xiaoqing,SHI Chuangang..Ultrasound-guided knee joint cavity injection： its effect on patient satisfaction， joint function and quality of life[J].journal interventional radiology,2021,30(02):1040.

备注/Memo

备注/Memo:
（收稿日期：2020-12-11）
（本文编辑：新　宇）
更新日期/Last Update: 2023-03-03