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外科研究与新技术 ›› 2019, Vol. 8 ›› Issue (3): 160-162.doi: 10.3969/j.issn.2095-378X.2019.03.004

• 论著 • 上一篇    下一篇

超声引导下肌间沟与腋路入路行臂丛神经阻滞在桡骨远端骨折手术中应用比较

许雪娜, 田皇华   

  1. 无锡市第八人民医院麻醉科,无锡 214000
  • 收稿日期:2019-07-11 出版日期:2019-09-28 发布日期:2019-12-05
  • 作者简介:许雪娜(1985—),女,大学本科,主治医师,从事临床康复外科工作;电子信箱:wt8196@163.com

Comparison between ultrasound-guided interscalene approach and axillary artery approach of brachial plexus block in distal radius fracture surgery

XU Xuena, TIAN Huanghua   

  1. Department of Anesthesiology, Wuxi Eighth People’s Hospital, Wuxi 214000, China
  • Received:2019-07-11 Online:2019-09-28 Published:2019-12-05

摘要: 目的 比较超声引导下肌间沟与腋路入路行臂丛神经阻滞在桡骨远端骨折手术中应用效果。方法 选择2018年1月—2018年12月行桡骨远端骨折手术的患者106例,应用随机数表法分为两组,各53例。入选者均实施臂丛神经阻滞,观察组在超声引导下选取腋路入路,对照组选取肌间沟入路。观察两组支配术区神经痛觉消失时间、麻醉效果及并发症。结果 观察组前臂内侧皮神经、正中神经、尺神经痛觉消失时间分别为(10.18±4.32) min、(13.50±7.06) min、(8.13±4.27) min,较对照组相应时间[(18.04±6.79) min、(19.72±8.14) min、(21.16±6.39) min]缩短,麻醉优秀效果占比(90.57%)较对照组(69.81%)高,麻醉失败占比(3.77%)较对照组(15.09%)低,差异有统计学意义(P<0.05)。两组前臂外侧皮神经、桡神经痛觉消失时间、并发症发生率对比,差异无统计学意义(P>0.05)。结论 桡骨远端骨折手术患者接受超声引导下腋路臂丛神经阻滞并发症少且麻醉效果确切,有利于提升神经阻滞效果。

关键词: 桡骨远端骨折, 超声引导, 臂丛神经阻滞, 肌间沟入路, 腋路入路, 麻醉效果

Abstract: Objective To compare the effects of ultrasound-guided interscalene approach and axillary artery approach of brachial plexus block in distal radius fracture surgery.Methods A total of 106 patients undergoing distal radius fracture surgery in our hospital from January to December 2018 were selected and divided into two groups by random number table, with 53 cases in each group.All selected cases received brachial plexus block, the observation group was given ultrasound-guided axillary artery approach, and the control group was given interscalene approach.The disappearance time of neuralgia, anesthetic effect, and complications in the two groups were observed.Results The neuralgia disappearance time of medial cutaneous nerve of forearm, median nerve, and ulnar nerve in the observation group [(10.18±4.32) min, (13.50±7.06) min, and (8.13±4.27) min] were shorter than the time of the control group [(18.04±6.79) min, (19.72±8.14) min, and (21.16±6.39) min]; the rate of successful anesthesia in the observation group (90.57%) was higher than that in the control group (69.81%); and the rate of anesthesia failure in the observation group (3.77%) was lower than that in the control group (15.09%) (P<0.05).There were no statistical differences in the neuralgia disappearance time of lateral cutaneous nerve of forearm and musculospiral nerve and the incidence rate of complications between the two groups (P>0.05).Conclusion Ultrasound-guided axillary artery approach of brachial plexus block for patients with distal radius fracture surgery produces less complications and good anesthetic effect, which can increase the effect of nerve block.

Key words: Distal radius fracture, Ultrasound-guided, Brachial plexus block, Interscalene approach, Axillary approach, Anesthetic effect

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