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中国临床药理学与治疗学 ›› 2024, Vol. 29 ›› Issue (5): 561-568.doi: 10.12092/j.issn.1009-2501.2024.05.011

• 药物治疗学 • 上一篇    下一篇

经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉在妊娠合并卵巢肿瘤中的应用

朱诚程1,2,罗永红2,丁锦2,程慧娴3,倪观太1,2   

  1. 1安徽医科大学,合肥  230032,安徽;2皖南医学院第一附属医院妇产科,3麻醉科,芜湖  241000,安徽
  • 收稿日期:2024-01-08 修回日期:2024-03-16 出版日期:2024-05-26 发布日期:2024-04-16
  • 通讯作者: 倪观太,男,主任医师,教授,博导,研究方向:妇科肿瘤。 E-mail: ngtiger@aliyun.com
  • 作者简介:朱诚程,女,在读博士,副主任医师,副教授,研究方向:妇科肿瘤。 E-mail: zccwyzdj@163.com
  • 基金资助:
    国家青年科学基金项目(82201820);皖南医学院校重点科研项目(WK2023ZZD18);中国临床试验注册中心项目(CTR2200059289);皖南医学院弋矶山医院管理与服务创新重点项目(CX2023006)

Application of pneumoperitoneum-free single-hole endoscopy combined with ropivacaine in pregnancy with ovarian tumor

ZHU Chengcheng1,2, LUO Yonghong2, DING Jin2, CHENG Huixian3, NI Guantai1,2   

  1. 1 Anhui Medical University, Hefei 230032, Anhui, China; 2 Obstetrics and Gynecology Department, 3 Anesthesiology Department, the First Affiliated Hospital of Wannan Medical College, Wuhu 241000, Anhui, China
  • Received:2024-01-08 Revised:2024-03-16 Online:2024-05-26 Published:2024-04-16

摘要:

目的:研究妊娠合并卵巢肿瘤患者应用经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉的临床疗效及安全性。方法:28例妊娠患者合并卵巢肿瘤行经脐无气腹单孔腔镜手术,按随机数字表分2组,观察组16例采用腰麻联合缝皮前罗哌卡因浸润麻醉,对照组12例采用腰麻,比较两组孕妇术后首次下床时间、通气时间、术后住院天数,术后6 h无创血压、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2),Ramsay镇静评分、术后6、24、48 h静息和运动状态下的疼痛评分,SAS焦虑评分、术后并发症、患者满意度、恢复质量表QoR15。结果:两组比较,术后住院天数、Ramsay评分、RR、SpO2及并发症发生率差异无统计学意义(P>0.05);观察组下床时间、通气时间缩短,无创血压、HR、疼痛评分、焦虑评分低于对照组,患者满意度、QoR15评分优于对照组,差异有统计学意义(P<0.05)。结论:妊娠合并卵巢肿瘤患者应用经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉,可以减轻术后疼痛,减少孕妇焦虑,临床效果良好,值得推广应用。

关键词: 单孔腹腔镜, 无气腹手术, 罗哌卡因, 妊娠, 卵巢肿瘤

Abstract:

AIM: To evaluate the clinical efficacy and safety of pneumoperitoneum-free single-hole endoscopy combined with ropivacaine local infiltration anesthesia in pregnancy with ovarian tumor. METHODS: Twenty-eight pregnant women with ovarian tumor were randomly divided into two groups: observation group (n=16) and control group (n=12). The first time out of bed, ventilation time, postoperative hospital stay, non-invasive blood pressure, heart rate (HR), respiratory frequency (RR) and blood oxygen saturation (SpO2) were compared between the two groups. Pain score, Ramsay sedation score, SAS anxiety score, postoperative complications, patient satisfaction and recovery quality scale QoR15 were evaluated at 6, 24 and 48 hours after operation. RESULTS: There was no significant difference in postoperative hospital stay, Ramsay score, RR, SpO2 and the incidence of complications between the two groups(P>0.05), but the time of getting out of bed and ventilation time were shortened, the scores of non-invasive blood pressure, HR, pain and anxiety in the observation group were lower than those in the control group, and the scores of patient satisfaction and QoR15 in the observation group were better than those in the control group (P<0.05). CONCLUSION: The application of pneumoperitoneum-free single-hole endoscope combined with ropivacaine local infiltration anesthesia in pregnancy with ovarian tumor can reach satisfactory clinical results, including reducing postoperative pain and anxiety, which is worth popularizing. 

Key words: single-hole laparoscopy, pneumoperitoneum-free, ropivacaine, pregnancy, ovarian tumor

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