【摘要】 目的探讨对行吻合器痔上黏膜环切术(PPH)治疗患者,术中采取神经刺激仪定位阴道下阴部神经阻滞的镇痛效果。方法随机选取300例行PPH治疗的患者为研究对象,分成观察组与对照组,每组各150例,对照组术后采取肛周多点局部麻醉的方式进行镇痛,观察组则采取神经刺激仪引导下阴部神经阻滞的方式进行镇痛,观察两组术后镇痛效果。结果观察组术后6 h、12 h疼痛评分显著低于对照组(P<0.05),而术后24 h与48 h两组疼痛评分无显著差异(P>0.05);观察组术后首次疼痛时间较对照组长,在术后48 h内追加曲马多的剂量上观察组也明显少于对照组,差异均有统计学意义(P<0.05);观察组术后不良反应总发生率为5.33%,明显低于对照组16.67%的总发生率(P<0.05)。结论对行PPH治疗的患者,术中应用神经刺激仪引导下阴部神经阻滞的方式可取得满意的镇痛效果,值得推广。更多还原

【Abstract】 Objective To investigate the analgesic effect of using neurostimulator to locate the vaginal inferior pudendal nerve block in patients undergoing hemorrhoids superior mucosa circumferential resection(PPH)with stapler. Methods 300 patients treated with PPH were randomly selected as research objects,and they were divided into observation group and control group,with 150 cases in each group. The control group received perianal multi-point local anesthesia for analgesia,and the observation group received neurostimulator guided pudendal nerve block for analgesia. The postoperative analgesia effect of the two groups was observed. Results The pain scores of the observation group were significantly lower than those of the control group at 6 h and 12 h postoperatively(P<0.05),while there was no significant difference between the two groups at 24 h and 48 h postoperatively(P> 0.05). The duration of the first postoperative pain in the observation group was longer than that in the control group,and the dose of tramadol within 48 days after the operation was also significantly less in the observation group than in the control group,with statistically significant difference(P<0.05). The total incidence of postoperative adverse reactions in the observation group was 5.33%,which was significantly lower than that in the control group(P<0.05). Conclusion The analgesic effect of using neurostimulator to guide inferior pudendal nerve block in patients with PPH is satisfactory and worth popularizing.更多还原