摘要
目的：探讨超声定位行锁骨下喙突入路臂丛神经麻醉的效果及安全性。方法：选取行前臂和手部手术的90例患者随机均分为A、B两组,A组采用超声定位锁骨下喙突入路臂丛麻醉,B组采用超声腋窝处定位臂丛麻醉;观察两组患者的正中神经、尺神经、肌皮神经、臂内侧皮神经的痛觉消失时间,测定两组患者臂丛神经阻滞效果、阻滞后肌力及并发症情况。结果：A组和B组患者的正中神经、尺神经、肌皮神经、臂内侧皮神经的痛觉消失时间差异无统计学意义（P＞0.05）,A组患者的桡神经、前臂内侧皮神经的痛觉消失时间显著短于B组患者（P＜0.05）;神经阻滞20min后,A组患者的前臂内侧皮神经的痛觉完全阻滞率高于B组患者（P＜0.05）,A组和B组患者的肌力分布差异无统计学意义（P＞0.05）;A组未出现刺破血管、气胸、局麻醉药中毒等并发症,B组出现3例刺破血管、2例轻度局麻药中毒,A组的麻醉并发症率显著低于B组（χ2=5.294,P=0.021）。结论：超声定位定位锁骨下喙突入路臂丛神经麻醉的效果好安全性高。
Objective： To investigate the effectiveness and safety of anesthesia in ultrasound guided infraclavieular coraeoid approach of braehial plexus. Methods： 90 cases of forearm and hand surgery patients were enrolled in the research object, and divided into group A and group B（45 cases in each group）. Group A were treated with ultrasound guided infraelavieular coracoid approach braehial plexus anesthesia, while group B was treated with ultrasound at the location of axillary brachial plexus anes- thesia. The median nerve, ulnar nerve, muscle cutaneous nerve, the medial brachial cutaneous nerve pain disappearing time were compared between the two groups. The brachial plexus nerve block effect, posterior muscle strength and complications were measured in the two groups of patients. Results： There were no statistically significant differences between group A and group B in pain disappearing time of the median nerve, ulnar nerve, muscle cutaneous nerve, medial brachial cutaneous nerve （ P 〉 0.05 ）. However, the pain disappearing time of radial nerve and medial cutaneous nerve of forearm in group A was significantly shorter than those in group B （P 〈 0.05 ）. After 20 min of nerve block, the complete block rate of pain of the medial forearm cutaneous nerve of a group was higher than that of group B （P 〈 0.05 ）, but there was no statistically significant difference in the muscle strength distri- bution between the group A and group B （P 〉 0. 05 ）. There existed no vascular puncture, pneumotho- rax, local anesthetics poisoning and other complications in group A, and there were 3 cases of vascularpuncture and 2 cases of mild local anesthetics poisoning in group B. The anesthesia complication rate in group A was significantly lower than that of group B（X2 =5. 294, P =0. 021 ）. Conclusion： Anes- thesia in ultrasound guided infraclavicular coracoid approach of brachial plexus has good effect, quick effect, less complications.
出处
《贵州医科大学学报》
CAS
2016年第12期1470-1473,共4页
Journal of Guizhou Medical University
关键词
超声检查
锁骨
喙突入路
臂丛神经
麻醉
uhrasonography
clavicle
coracoid approach
brachial plexus
anesthesia
