腕部神经一针三点阻滞的临床研究  

Clinical study of the carpal nerve block with one needle for three points

作　　者：夏英松 易锡圭 刘静 郭明金 周文君 别敏燕 

机构地区：[1]湘潭钢铁公司职工医院,湖南湘潭411101

出　　处：《中国冶金工业医学杂志》2001年第4期201-203,共3页Chinese Medical Journal of Metallurgical industry

基　　金：湘潭钢铁集团有限公司资助科研项目

摘　　要：目的 :探讨手部手术实施腕部神经一针三点阻滞的穿刺方法与麻醉效果。方法 :计划观察手部手术 1 2 0例 ,对照组 (传统臂丛方法组 ) 36例 ,腕部阻滞组 84例 (其中正中 +尺、桡神经阻滞 52例、正中 +尺神经阻滞 1 0例、正中桡神经阻滞 2 2例 )。观察各组神经阻滞区域及麻醉效果 (满意率 ) ,各组注药前后Bp、HR、R、SPO2 的变化 ,术中辅助用药及并发症或不良反应。结果 :麻醉满意率腕部阻滞组 (92 9% ) ,明显高于对照组 (75 % ) (P <0 0 2 ) ,其中腕部阻滞组满意率正中 +尺、桡神经阻滞占 94 2 %、正中 +尺神经阻滞占 1 0 0 %、正中 +桡神经阻滞占 86 5 % ;对照组正中 +尺、桡神经阻滞占 75 %。组内注药前后比较 :腕部阻滞组Bp与对照组R无显著差异 (P >0 0 5) ,而腕部阻滞组HR、R、SPO2 与对照组BR、HR、SPO2 注药前后虽有显著差异 (P <0 0 5 ,P <0 0 1 ) ,但均在正常范围。两组术中辅助用药 ,对照组 (72 2 % )明显高于腕部阻滞组(1 7 4% ) (P <0 0 1 )。各组术中均无并发症及不良反应。结论 :手部手术行腕部神经一针三点或一针二点阻滞的麻醉方法是一种简便、安全、实用且较为理想的方法 。Objective:To assess the anesthesia effect of one needle for three points method for hand surgery.Methods:One hundred and twenty patients were divided into two groups.Thirty-six patients(control group) received brachial plexus block.Eighty-four patients (experimental group) received carpal nerve block with one needle for three points (fifty-two patients received median nerve,ulnar nerve,and radial nerve combined block and ten patients received median nerve and ulnar nerve block).The anesthesia effect of each group (the satisfaction rate) was assessed by monitering the change of BP,HR,R,SPO 2 before and after anesthesia.The drugs used during operation,complications or side effects were recorded.Results:The satisfaction rate of anesthesia effect was 92 9% in experimental group(94 2% for median nerve,ulnar nerve and radial nerve combined block and 100% for median nerve and ulnar nerve block) and 75% in the controll group (P<0 02).The dissatisfaction rate of anesthesia effect was 25% in the controll group and 7 1% in experimental group (P<0 05)?There was no significant difference in the change of Bp in the experimental group and R in the controll group.There was significant difference in the chrome of HR R.SPO 2 in the experiment group and Bp.HR.SPO 2 in the controll group before and after anesthesia.But they were all in normal range.There were 72 2% in the controll group and 17 4% in the experimental group on drugs used during operation.There was no complication and side effect in both groups. Conclusions:The carpal nerve block with one needle for three points or one needle for two points may be an easy,safe and useful anesthesia method for handsurgery.

关 键 词：腕部 一针三点 神经阻滞 麻醉 

分 类 号：R614[医药卫生—麻醉学]