摘要
目的观察臂丛神经阻滞在动静脉内瘘成形术中的效果。方法拟行动静脉内瘘成形术患者152例,随机均分为臂丛神经阻滞组和局部浸润麻醉组。臂丛神经阻滞组手术中采用臂丛神经阻滞法进行麻醉,局部浸润麻醉组术中给予局部浸润麻醉法。比较两组术中VAS疼痛评分、术中血管直径、术后4h内瘘血流量、手术时间、术后24h和术后2年的手术成功率及麻醉安全性。结果臂丛神经阻滞组VAS疼痛评分、手术时间明显低于局部浸润麻醉组(P<0.01);臂丛神经阻滞组术中动脉直径、术中静脉直径和内瘘血流量明显高于局部浸润麻醉组(P<0.01)。臂丛神经阻滞组术后24h手术成功率为98.68%,与局部浸润麻醉组的92.11%差异无统计学意义;但臂丛神经阻滞组术后2年手术成功率为88.16%,明显高于局部浸润麻醉组的75.00%(P<0.05)。两组均未见明显药物不良反应。结论臂丛神经阻滞可减轻术中疼痛,提高动静脉内瘘成形术手术成功率。
Objective To assess the efficacy of brachial plexus block in patients undergoing arteriovenous fistula angioplasty.Methods One hundred fifty-two patients accepted arteriovenous fistula angioplasty were randomly divided into the brachial plexus block group or the local infiltration anesthesia group.They all accepted the conventional treatment,but the patients in the brachial plexus block group accepted brachial plexus block,while the patients in the local infiltration anesthesia group accepted local infiltration anesthesia.The difference of the VAS score,intraoperative vascular diameter,4hpostoperative fistula blood flow,operation time,24 hpostoperative successful rate of operation,2years postoperative successful rate of operation and anesthesia safety were compared between the two group.Results The VAS score and intraoperative vascular diameter in the brachial plexus block group were significantly lower than that in the local infiltration anesthesia group（P〈0.01）,the intraoperative arterial diameter,intraoperative venous diameter and the blood flow of arteriovenous fistula in the brachial plexus block group were significantly higher than that in the local infiltration anesthesia group（P〈0.01）.There was no significant difference of 24 hpostoperative successful rate of operation between the two groups,but the two years postoperative successful rate of operation in the brachial plexus block group were significantly higher than that in the local infiltration anesthesia group（P〈0.05）.Conclusion The brachial plexus block could relieve intraoperative pain and improve the successful rate of operation in patients accepted arteriovenous fistula angioplasty.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2014年第11期1095-1097,共3页
Journal of Clinical Anesthesiology
关键词
臂丛神经阻滞
局部浸润麻醉
动静脉内瘘成形术
Brachial plexus block
Local infiltration anesthesia
Arteriovenous fistula angioplasty
