超声引导下局部肿胀麻醉与硬膜外麻醉行大隐静脉剥脱术的临床对比研究
发布时间：2019-01-02 15:09
【摘要】：目的：通过对比研究两种不同的麻醉方式下行大隐静脉剥脱术的效果,探讨超声引导下局部肿胀麻醉行大隐静脉剥脱术的可行性。观察此方式的临床治疗效果,并总结出此方式治疗大隐静脉曲张的优缺点,进一步发现超声引导下局部肿胀麻醉行大隐静脉剥脱术的不足,补充完善此项技术的相关研究。方法：1、选择我院住院符合诊断标准、纳入标准和排除标准的大隐静脉曲张60例患者。采用完全随机分组法将其分为实验组(超声引导下局部肿胀麻醉下行大隐静脉高位结扎+内剥脱+微静脉切除术)及对照组(硬膜外麻醉下行大隐静脉高位结扎+内剥脱+微静脉切除术),二组各30例患者进行治疗,最后根据手术时间,术中剥脱大隐静脉主干时的血压、心率,术后VAS疼痛分数,术后卧床活动时间,术后并发症以及经济效益等判定两种不同麻醉方式的效果。2、借助统计学方法,比较二组的效果差别,从而得出超声引导下局部肿胀麻醉下行大隐静脉剥脱术的可行性,通过与硬膜外麻醉行大隐静脉剥脱术的效果比较,从而进一步完善此麻醉方式的相关研究。结果：1、本次研究共收集60例患者(83条肢体),实验组30例(44条肢体),对照组30例(39条肢体),两组患者在性别、年龄、分级构成上差异无统计学意义(P0.05),两组数据具有可比性。2、超声引导下局部肿胀麻醉行大隐静脉剥脱术与硬膜外麻醉行大隐静脉剥脱术在手术时间、恶心呕吐上差异无统计学意义(P0.05)。3、实验组在术后VAS疼痛分数、术后卧床活动时间、术后尿潴留、术后下肢深静脉血栓、术后住院时间以及住院费用上低于对照组,其差异具有统计学意义(P0.05)。4、对照组在术中剥脱大隐静脉主干时的血压、心率波动上低于实验组,其差异具有统计学意义(P0.05)。结论：超声引导下局部肿胀麻醉与硬膜外麻醉用于大隐静脉主干剥脱上均具有简单、安全、疗效好的特点。超声引导下局部肿胀麻醉行大隐静脉剥脱术术后能够快速康复,能有效避免麻醉术后并发症及深静脉血栓的形成,减轻术后疼痛,同时可降低患者住院费用,减轻患者经济压力。因此,该麻醉方式在大隐静脉主干处理上有较好的应用前景。
[Abstract]:Objective: to study the effect of two different anaesthesia methods on saphenous vein exfoliation and to explore the feasibility of local swelling anesthesia under ultrasound guidance. The clinical effect of this method was observed and the advantages and disadvantages of the treatment of varicose great saphenous vein were summarized. Methods: 1. 60 patients with varicose great saphenous vein were selected. It was divided into experimental group (high ligation of great saphenous vein under ultrasound-guided high ligation of saphenous vein) and control group (high ligation of great saphenous vein under epidural anesthesia). Exfoliation of venipuncture), According to the time of operation, the blood pressure, heart rate, VAS pain score, the time of bed rest after operation, the heart rate, the time of operation, and the time of bed rest, according to the time of operation, the heart rate, the pain score of VAS and the time of bed rest after operation. Postoperative complications and economic benefits were used to determine the effects of two different anesthetic methods. 2. By means of statistical method, the difference between the two groups was compared, and the feasibility of local swelled anesthesia under ultrasound guidance was obtained in the removal of great saphenous vein. By comparing with epidural anesthesia the effect of great saphenous vein exfoliation was compared to further improve the related study of this anesthesia. Results: 1. There were 60 patients (83 limbs) in this study, 30 in experimental group (44 limbs) and 30 in control group (39 limbs). There was no significant difference in sex, age and grade composition between the two groups (P0.05). The data of the two groups were comparable. (2) there was no significant difference in the operation time, nausea and vomiting between the local swelling anesthesia and epidural anesthesia under the guidance of ultrasound (P0.05), and there was no significant difference between the two groups in the time of operation, nausea and vomiting (P0.05), and there was no significant difference between the two groups in the time of operation (P0.05). The scores of postoperative VAS pain, postoperative bed rest time, postoperative urinary retention, postoperative deep vein thrombosis, postoperative hospitalization time and hospitalization cost in the experimental group were significantly lower than those in the control group (P0.05). The blood pressure and heart rate fluctuation of the control group were lower than that of the experimental group during the operation of stripping the main trunk of the great saphenous vein. The difference was statistically significant (P0.05). Conclusion: Ultrasound-guided local swelling anesthesia and epidural anesthesia are simple, safe and effective for stripping the main trunk of saphenous vein. Ultrasound-guided local swelling anesthesia with great saphenous vein exfoliation can recover quickly, can effectively avoid complications after anesthesia and the formation of deep venous thrombosis, alleviate postoperative pain, and reduce the cost of hospitalization. Reduce the patient's economic pressure. Therefore, the anesthesia has a good prospect in the treatment of saphenous vein trunk.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R654.4
本文编号：2398653
[Abstract]:Objective: to study the effect of two different anaesthesia methods on saphenous vein exfoliation and to explore the feasibility of local swelling anesthesia under ultrasound guidance. The clinical effect of this method was observed and the advantages and disadvantages of the treatment of varicose great saphenous vein were summarized. Methods: 1. 60 patients with varicose great saphenous vein were selected. It was divided into experimental group (high ligation of great saphenous vein under ultrasound-guided high ligation of saphenous vein) and control group (high ligation of great saphenous vein under epidural anesthesia). Exfoliation of venipuncture), According to the time of operation, the blood pressure, heart rate, VAS pain score, the time of bed rest after operation, the heart rate, the time of operation, and the time of bed rest, according to the time of operation, the heart rate, the pain score of VAS and the time of bed rest after operation. Postoperative complications and economic benefits were used to determine the effects of two different anesthetic methods. 2. By means of statistical method, the difference between the two groups was compared, and the feasibility of local swelled anesthesia under ultrasound guidance was obtained in the removal of great saphenous vein. By comparing with epidural anesthesia the effect of great saphenous vein exfoliation was compared to further improve the related study of this anesthesia. Results: 1. There were 60 patients (83 limbs) in this study, 30 in experimental group (44 limbs) and 30 in control group (39 limbs). There was no significant difference in sex, age and grade composition between the two groups (P0.05). The data of the two groups were comparable. (2) there was no significant difference in the operation time, nausea and vomiting between the local swelling anesthesia and epidural anesthesia under the guidance of ultrasound (P0.05), and there was no significant difference between the two groups in the time of operation, nausea and vomiting (P0.05), and there was no significant difference between the two groups in the time of operation (P0.05). The scores of postoperative VAS pain, postoperative bed rest time, postoperative urinary retention, postoperative deep vein thrombosis, postoperative hospitalization time and hospitalization cost in the experimental group were significantly lower than those in the control group (P0.05). The blood pressure and heart rate fluctuation of the control group were lower than that of the experimental group during the operation of stripping the main trunk of the great saphenous vein. The difference was statistically significant (P0.05). Conclusion: Ultrasound-guided local swelling anesthesia and epidural anesthesia are simple, safe and effective for stripping the main trunk of saphenous vein. Ultrasound-guided local swelling anesthesia with great saphenous vein exfoliation can recover quickly, can effectively avoid complications after anesthesia and the formation of deep venous thrombosis, alleviate postoperative pain, and reduce the cost of hospitalization. Reduce the patient's economic pressure. Therefore, the anesthesia has a good prospect in the treatment of saphenous vein trunk.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R654.4
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