摘要目的 探讨超声引导腹横肌平面阻滞（TAPB）对开腹手术患者术后转归的影响。方法 选取我院2017年10月～2018年10月收治的60例开腹手术患者作为研究对象，按照随机数字表法分为T和C组，每组各30例。T组为TAPB组，术后采用TAPB+静脉自控镇痛（PCA）；C组为对照组，术后采用PCA。比较两组术后不同时间点疼痛视觉模拟（VAS）评分、舒适度（BCS）评分、术后24 h PCA按压次数和患者对治疗的满意度、两组术后相关并发症发生情况。结果> 两组比较，在 2、4、6、8、12 h时间点 T 组 VAS评分明显低于 C 组（P＜0.05），BCS评分高于 C 组（P＜0.05），差异有统计学意义。24 h时间点两组VAS、BCS评分比较，差异无统计学意义（P＞0.05）。比较两组术后镇痛泵按压次数，T组少于C组（P＞0.05），治疗满意度T组高于C组（P＜0.05），两组术后恶心呕吐发生率和呼吸抑制发生率比较，差异无统计学意义（P＞0.05）。T组未观察到TAPB相关并发症的发生。结论 超声引导TAPB符合精准麻醉和加速康复外科的理念，为开腹患者提供良好的镇痛效果，对疾病的转归产生积极的影响，值得临床大力推广。
Abstract：Objective To observe the effects of ultrasound-guided transversus abdominis plane block (TAPB)on postoperative outcome of patients undergoing open abdominal surgery.Methods A total of 60 patients who underwent laparotomy in our hospital from October 2017 to October 2018 were selected as the study subjects,and they were divided into group T(30 cases)and group C(30 cases)according to random number table method.TAPB and patient-controlled intravenous analgesia(PCA)were performed after operation in group T.PCA was performed after operation in group C.Pain visual analogue scale (VAS),Bruggrmann comfort scale(BCS),PCA compression times,satisfaction degree and postoperative complications at different time points were compared between the two groups.Results VAS score in group T was significantly lower than in group C at 2,4,6,8 and 12 hours (P＜0.05),and BCS score was significantly higher than in group C (P＜0.05).At 24 hours in group T and group C,VAS BCS scores were not statistically significant(P＞0.05).Times of pressing analgesia pump in group C was higher than in group T (P＜0.05),and satisfaction degree in group T was higher than in group C (P＜0.05).There were no significant differences in incidence of nausea,vomiting and respiratory depression between group T and group C(P＞0.05),and no complications of TAPB were observed in group T.Conclusion TAPB is consistent with precise anesthesia and enhanced recouery after surgery.It provides effective analgesic for open abdominal patients and positive impacts on the prognosis of abdominal surgery.It is worthy of promoting in clinical.
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