| 摘要: |
| 目的：探讨超声引导下隐筋膜间隙肿胀液麻醉在大隐静脉激光闭合术中的应用效果。方法：收取我院20155月到2016年3月收治的择期进行大隐静脉激光闭合术患者60例，按照随机数字表法分为观察组和对照组，每组30例，患者均进行大隐静脉激光闭合术治疗，观察组在超声引导下给予超声引导下分段穿刺隐筋膜间隙注入肿胀液麻醉配合芬太尼静脉清醒镇痛，对照组给予传统的腰麻，观察两组麻醉效果。结果：阻滞起始时间组间差异无统计学意义（P>0.05），观察组阻滞成功率为100.0%，对照组为96.7%，差异无统计学意义（P>0.05）；阻滞感觉评分在麻醉后5min观察组评分高于对照组，差异具有统计学意义（P<0.05），麻醉后15、25、30min评分组间差异无统计学意义（P>0.05）；观察组手术开始即刻HR平均值高于对照组值，差异具有统计学意义（P<0.05），术前、术后15min、30min HR和MAP组间差异均无统计学意义（P>0.05）;术后麻醉恢复即刻、术后 2h VAS评分组间差异无统计学意义（P>0.05），观察组术后4、6、8h VAS评分均低于对照组评分，差异具有统计学意义（P<0.05），观察组和对照组术后6h VAS评分均最高，并且8h后降低，差异显著（P<0.05）。结论：超声引导下隐筋膜间隙肿胀液麻醉应用于大隐静脉激光闭合术加散在曲张静脉点式剥脱术中，可替代传统腰麻，且安全、可靠、方便，尤其适合于单纯大隐静脉曲张患者，对于小腿段有大量散在曲张静脉者，疼痛较明显。 |
| 关键词: 大隐静脉激光闭合术 隐筋膜间隙 肿胀液麻醉 超声 |
| DOI： |
| 投稿时间：2016-12-24修订日期：2016-12-24 |
| 基金项目: |
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| Application of anesthesia in endovenous laser closure in a hidden compartment swelling solution under ultrasound guidance |
| chenlei |
| () |
| Abstract: |
| Objective: To investigate the effect of anesthesia in great saphenous vein endovenous laser treatment in a hidden compartment swelling liquid ultrasonic guidance. Methods: collected in our hospital from 20155 months to March 2016 were undergoing saphenous vein in patients with endovenous laser treatment in 60 cases, were randomly divided into observation group and control group, 30 cases in each group, patients were treated with endovenous laser treatment treatment, the observation group under the guidance of ultrasound for ultrasound guided puncture segmental hidden fascia clearance swelling liquid injection anesthesia with fentanyl intravenous conscious sedation, control group was given conventional spinal anesthesia, observe two groups of anesthesia. Results: there was no significant difference between group block onset time (P>0.05), the observation group success rate was 100%, 96.7% in the control group, the difference was not statistically significant (P>0.05); block sensory score 5min after anesthesia in the observation group were higher than those of the control group, the difference was statistically significant (P<0.05), no statistical significance after anesthesia 15 25, the 30min score differences between groups (P>0.05); observation group surgery immediately after the beginning of the average value of HR is higher than that of control group, the difference was statistically significant (P<0.05), preoperative and postoperative 15min, HR and 30min differences between the MAP group had no statistical significance (P>0.05); recovery after anesthesia, immediate surgery after 2H VAS scores were no significant differences (P>0.05) were observed in 4, 6, 8h, VAS group after operation were lower than the control group score, the difference was statistically significant (P<0.05), the observation group and the control The 6h VAS score was highest after operation and decreased after 8h, the difference was significant (P<0.05). Conclusion: anesthesia in endovenous laser treatment plus powder peeling in varicose vein type in a hidden compartment swelling liquid ultrasonic guidance, can replace the traditional spinal anesthesia, which is safe, reliable and convenient, especially suitable for patients with simple varicose vein, with a large number of scattered in the varicose vein for leg. The pain is obvious. |
| Key words: Endovenous laser treatment hidden compartment tumescent anesthesia ultrasound |
