摘要
目的探讨超声引导下肌间沟联合腋路臂丛神经阻滞的麻醉效果。方法 46例臂丛麻醉下行上肢手术患者随机分为研究组和对照组,每组各23例,两组患者均使用局部麻醉,其中对照组采用传统解剖定位下肌间沟臂丛阻滞,研究组采用超声引导下肌间沟联合腋路臂丛神经阻滞。比较两组的穿刺时间以及麻醉后各主要神经的痛觉阻滞情况。结果研究组一次操作成功率显著高于对照组(100%vs 73.9%)(χ~2=4.367,P<0.05);研究组操作时间明显短于对照组(P<0.05)。研究组中腋神经、正中神经、尺神经、桡神经、臂内侧皮神经、肌皮神经、前臂内侧皮神经等各神经分支的感觉阻滞起效时间及平均时间均明显短于对照组(P<0.05)。研究组中腋神经、正中神经、尺神经、桡神经等各神经分支的运动阻滞起效时间及平均时间均明显短于对照组(P<0.05)。研究组穿刺并发症发生率为21.74%(5/23),显著低于对照组的52.17%(12/23)(χ~2=4.18,P<0.05)。结论与传统解剖定位相比,超声引导下肌间沟联合腋路臂丛神经阻滞的麻醉,具有阻滞操作时间短,一次操作成功率高、起效时间短、并发症少等优点。
Objective To study the anesthesia effect of ultrasound -guided interscalene combined with axillary brachial plexus block. Methods 46 cases with upper extremity surgery under brachial plexus anesthesia were divided into study group and control group,23 cases in each group. The two groups received local anesthesia. The control group was mainly received brachi- al plexus block with anatomical localization,while the study group was for ultrasound - guided interscalene combined with axillary brachial plexus block. The puncture time and pain block of major nerves in the two groups after anesthesia were analyzed. Results The operation success rate in the study group was significantly higher than that in the control group （ 100% vs 73.9%） （X2 =4. 367 ,P 〈 0. 05）and the operation time in the study group was significantly shorter than that in the control group（P 〈0.05）. The sensory block onset time and average time of axillary nerve,median nerve, ulnar nerve, radial nerve, medial brachial cutaneous nerve, musculocutaneous nerve and medial antebrachial cutaneous nerve in the study group were significantly shorter than those in the control group （P 〈 0.05）. The motor block onset time and average time of axillary nerve, median nerve, ulnar nerve and radial nerve in the study group were sig- nificantly shorter than those in the control group （P 〈0.05）. The puncture complications rate in the study group was 21.74% （5/23）,which was significantly lower than that in the control group 52.17% （12/23） （X2 = 4. 18, P 〈 0.05）. Conclusion The anesthesia of ultrasound - guided interscalene combined with axillary brachial plexus block had the advantages of higher block success rate,shorter operation time of block,block onset time and less complications.
出处
《湖北民族学院学报（医学版）》
2017年第2期11-14,共4页
Journal of Hubei Minzu University(Medical Edition)
关键词
超声
下肌间沟联合腋路
臂丛神经阻滞
上肢手术
ultrasound - guided
interscalene combined axillary
brachial plexus block
upper extremity surgery
