传统盲法与超声引导骶管阻滞学习曲线的比较  

COMPARISON OF THE LEARNING CURVES BETWEEN THE TRADITIONAL BLIND AND THE ULTRASOUND-GUIDED CAUDAL BLOCK

作　　者：何晨辉 解淑灿 王建光[2] 翁浩[2] 徐志勇[2] 朱新杰[2] 刘海健[2] 陈渔[2] 

机构地区：[1]南方医科大学附属第三临床医学院,广州510515 [2]南方医科大学附属奉贤医院麻醉科,上海201400

出　　处：《中国疼痛医学杂志》2015年第4期275-278,共4页Chinese Journal of Pain Medicine

基　　金：上海市奉贤区科学技术发展基金项目(奉科20141104)

摘　　要：目的:比较传统盲法与超声引导下进行骶管阻滞的学习曲线,确定何种方式穿刺成功率高、初学者易于掌握。方法:11名实习医生经高年资麻醉科医生培训,并在其监督指导下采用传统盲法与超声引导,为85名患者进行骶管阻滞治疗。每位实习医生采用两种穿刺方法分别为8名患者进行治疗,其中每种穿刺方法为4名患者进行骶管阻滞治疗,根据随机数字表决定采用何种穿刺方式。结果:85名需骶管注射疗法治疗腰痛症或骶管麻醉患者参与本次随机交叉对照研究,采用超声引导下(U组,n=42)骶管阻滞穿刺成功率及一次穿刺成功率明显高于传统盲组(N组,n=43);穿刺时间、平均穿刺次数明显低于N组;不良反应发生率显著低于N组(P<0.05)。结论:与传统盲法相比,采用超声引导下进行骶管阻滞,穿刺成功率高、时间短、不良反应发生率低,更易于初学者掌握。Objective： To compare the learning curves of the traditional blind method with the ultrasoundguided method in caudal block and to determine which one is more suitable for the novices. Methods： 11 interns trained by experienced anesthesiologists were enrolled in this study. They performed caudal block on 8 patients by the traditional blind and ultrasound-guided（each method for 4 patients） under the supervision of experienced anesthesiologists, respectively. The choice of the method of caudal block was determined by computer-generated random number list. Results： 85 patients who were ready to receive caudal block were enrolled in this randomized crossover controlled study. The success rate of puncture and the one-time puncture in the group of ultrasound-guided caudal block（group U, n = 42） were significantly higher than those in the group of traditional blind caudal block. The group U was significantly lower than group N in average time, number of times, and incidence of adverse reactions of puncture（P〈0.05）. Conclusion： With the advantages of a faster learning curve, higher success rate of puncture, shorter puncture time and lower incidence of adverse reaction, ultrasound-guided caudal block is easier to master for the novices.

关 键 词：超声 骶管阻滞 腰椎间盘突出症 学习曲线 

分 类 号：R614[医药卫生—麻醉学]