中国当代医药2025，Vol.32Issue(9)：90-95,6.DOI:10.3969/j.issn.1674-4721.2025.09.19
弓状韧带上腰方肌阻滞在腹腔镜肝叶切除术中的应用
Application of quadratus lumborum block at the lateral supra-arcuate ligament in laparoscopic hepatic lobectomy
摘要
Abstract
Objective To investigate the application of quadratus lumborum block at the lateral supra-arcuate ligament in laparoscopic hepatic lobectomy.Methods A total of 70 patients who underwent elective laparoscopic hepatic lobectomy in Qiannan People's Hospital from March 2023 to September 2024 were selected as the research objects,and they were divided into direct general anesthesia group(group C)and quadratus lumborum block combined general anesthesia group(group Q)according to random number table method,with 35 cases in each group.Endotracheal intubation was induced by direct general anesthesia in group C,and endotracheal intubation was induced by general anesthesia in group Q after bilateral quadratus lumborum block at the lateral supra-arcuate ligament.Both groups underwent surgery under controlled low central venous pressure.Visual analogue scale(VAS)scores for cough at 2,4,8,12 and 24 hours after surgery,total intraoperative opioid consumption,number of patient controlled analgesia(PCA)within 24 hours after surgery,the time of first postoperative walking out of bed,first postoperative anal exhaust,postoperative respiratory depression,nausea and vomiting,urinary retention,pruritus,chest tightness and other adverse reactions were recorded in both groups.Results The VAS scores of the group Q at 2,4,8,12 and 24 hours after surgery were lower than those of the group C,the differences were statistically significant(P＜0.05).There were no significant differences in VAS scores at 2,4,8,12 and 24 hours after surgery between the two groups(P＞0.05).The total intraoperative opioid consumption in group Q was lower than that in group C,the number of PCA within 24 h after surgery was lower than that in group C,the time of first postoperative walking out of bed and first postoperative anal exhaust was shorter than that in group C,with statistical significances(P＜0.05).The total incidence of postoperative adverse reactions in group Q was lower than that in group C,and the differ-ence was statistically significant(P＜0.05).Conclusion The application of quadratus lumborum block at the lateral supra-arcuate ligament in laparoscopic hepatic lobectomy can reduce postoperative cough pain score,intraoperative opioid dosage and the number of PCA within 24 h after surgery,shorten the time of first postoperative walking out of bed and first postoperative anal exhaust,and reduce the incidence of surgery-related adverse reactions.关键词
弓状韧带/腰方肌阻滞/腹腔镜/肝叶切除术/控制性低中心静脉压Key words
Arcuate ligament/Quadratus lumborum block/Laparoscopy/Hepatic lobectomy/Controlled low central venous pressure分类
医药卫生引用本文复制引用
杨静,姬魁权,何锴,龙明波,张永国,陈绿绿,陈华侨..弓状韧带上腰方肌阻滞在腹腔镜肝叶切除术中的应用[J].中国当代医药,2025,32(9):90-95,6.基金项目
黔南民族医学高等专科学校科研基金项目(Qnyz2024027). （Qnyz2024027）
