摘要
目的探讨糖尿病患者应用超声引导(UG)联合神经刺激仪(NS)引导下臂丛神经阻滞的临床效果。方法选择佛山市高明区人民医院2015年2月至2017年8月收治的98例择期行上肢手术的糖尿病患者,采用随机数表法分为对照组(49例,采用传统异感定位下臂丛神经阻滞)和观察组(49例,应用UG联合NS下臂丛神经阻滞),比较两组患者的麻醉效果及血液动力学变化。结果观察组和对照组患者的各神经痛觉阻滞起效时间[(6.47±1.63)vs(9.41±1.49)]、完善时间[(15.58±2.68)vs(22.28±22.49)]以及阻滞完善率(95.92%vs 57.14%)比较,观察组均明显优于对照组,差异均有统计学意义(P<0.05);观察组患者麻醉过程中各时点的收缩压(SBP)、舒张压(DBP)、HR与麻醉前比较,差异均无统计学意义(P>0.05);对照组麻醉后15 min、30 min和手术结束后的SBP、DBP和HR均明显低于麻醉前,差异均有统计学意义(P<0.05);观察组患者的麻醉效果优良率为91.84%,明显高于对照组的71.43%,并发症发生率为2.04%,明显低于对照组的14.29%,差异均有统计学意义(P<0.05)。结论糖尿病患者应用UG联合NS引导下臂丛神经阻滞可提高麻醉的精确、有效性,对血流动力学影响小,同时能缩短阻滞起效时间,减少并发症。
Objective To investigate the clinical effect of ultrasound guidance（UG） combined with nerve stimulator（NS） guided lower brachial plexus block in patients with type 2 diabetes mellitus. Methods A total of 98 diabetic patients who underwent elective upper limb surgery were selected in Foshan Gaoming District People＇s Hospital from Feb. 2015 to Aug. 2017. They were divided into control group（n=49, using traditional heterosensory for lower brachial plexus block） and observation group（n=49, applying UG combined with NS for lower brachial plexus block） accroding to random number table. The anesthetic effect and hemodynamic changes between the two groups were compared.Results The onset time of block, improvement time and nerve block completion rate in observation group were（6.47±1.63）,（15.58±2.68）, 95.92%, respectively, which were significantly better than（9.41±1.49）,（22.28±22.49）, 57.14% in control group（P〈0.05）. There were no significant difference in systolic blood pressure（SBP）, diastolic blood pressure（DBP） and heart rate（HR） at different time points in observation group compared with before anaesthesia（P〉0.05）. The SBP, DBP and HR in the control group at 15 min, 30 min after anesthesia and after operation were significantly lower than those before anesthesia（P〈0.05）. The excellent rate of anesthesia effect in the observation group was 91.84%,which was significantly higher than 71.43% in the control group, but the incidence of complications（2.04%） was significantly lower than（14.29%） in the control group（P〈0.05）. Conclusion UG and NS guided lower brachial plexus block can improve the accuracy and effectiveness of anesthesia in diabetic patients, which has little effect on hemodynamics,and can shorten the onset time of block and reduce complications.
作者
谢林碧
王敏
农兰依
钟爱群
王高强
廖炜佳
XIE Lin-bi;WANG Min;NONG Lan-yi;ZHONG Ai-qun;WANG Gao-qiang;LIAO Wei-jia(Department of Anesthesiology,Foshan Gaoming District People＇s Hospital,Foshan 528500,Guangdong,CHIN)
出处
《海南医学》
CAS
2018年第14期1972-1974,共3页
Hainan Medical Journal
基金
广东省佛山市科技局医学类科技攻关项目(编号:2016AB001134)
关键词
糖尿病
血流动力学
臂丛神经阻滞
超声
麻醉效果
Diabetes
Hemodynamics
Brachial plexus block （BPB）
Ultrasound
Anesthetic effect
