超声引导技术在连续臂丛阻滞中的应用  

Clinical application of ultrasound -guided technique in the continuous brachial plexus block

作　　者：马永兵 王志广 胡美新 潘宠勤 

机构地区：[1]浙江省荣军医院麻醉科,嘉兴314000 [2]浙江省荣军医院超声科

出　　处：《临床医学》2010年第2期27-28,共2页Clinical Medicine

基　　金：浙江省嘉兴市科技局立项课题(2007AY2038)

摘　　要：目的探讨超声引导技术在连续臂丛阻滞中应用的麻醉效果。方法将240例ASA分级Ⅰ～Ⅱ级的上肢手术患者随机分为两组,每组各120例:A组用超声引导技术下行连续臂丛神经阻滞;B组用盲探技术下行连续臂丛神经阻滞。结果A组麻醉优良率为96.67%,而B组优良率为81.67%,两组比较差异有统计学意义(P<0.05)。A组中只有4例需改用其他麻醉方法或加用其他方式神经阻滞,而B组有22例。A组并发症寒战、惊厥发生率,血管神经损伤及止血带反应率明显少于B组,差异有统计学意义(P<0.05)。结论超声引导下连续臂丛神经阻滞(腋部)运用于较长时间肘部以下手术是行之有效的,提高了穿刺、置管成功率,增加了麻醉效果的优良率,减少了并发症的发生率。Objective To investigate the anesthetic effect of ultrasound-guided technique in the continuous brachial plexus block. Methods Two hundred and forty ASA Ⅰ-Ⅱ patients scheduled for surgery of the upper extremity were randomly allocated into two groups and each group had 120 patients. Group A were treated by ultrasound-guided technique and group B by blind technique. Results The success rate of anesthesia in group A was 96. 67% ,while in group B was 81. 67% （ P〈0.05）. In group A,only 4 patients need to change anesthesia method or add other forms of nerve block while 22 patients in group B. The incidence of shiver and febrile seizures,vascular nerve injury and response rate of tourniquet was significantly higher in group B than group A（ P〈0.05）. Conclusion It is effectively to apply ultrasound-guided continuous brachial plexus block （axillary） to relatively long period of belowelbow surgery that greatly increased achievement ratio of puncturing indwelling catheter and decreased complications.

关 键 词：高频彩超 B超引导 腋路 连续臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]