三叶草法与短轴平面内法腰丛神经阻滞技术的超声成像对比分析  

Shamrock versus short-axis in-plane ultrasound guided methods in visualization of lumbar plexus block

作　　者：吕锐[1] 陈妍[1] 曾静[1] 杨纯勇[1] 曹剑[1] 易斌[1] 鲁开智[1] 

机构地区：[1]第三军医大学西南医院麻醉科,重庆400038

出　　处：《第三军医大学学报》2016年第15期1777-1780,共4页Journal of Third Military Medical University

摘　　要：目的比较超声引导下腰丛神经阻滞采用三叶草法(shamrock method)与短轴平面内法的超声成像效果差异,探讨两种技术的成像便捷性、显像范围及效果。方法选择2015年6-12月在第三军医大学西南医院因单侧膝关节半月板损伤需行腰丛神经阻滞麻醉的30例患者为研究对象,按随机数字表法随机分为三叶草法组和短轴平面内法组,每组15例。记录两组腰丛神经超声图像定位时间、腰丛深度、超声评分(UVS)及超声显像区域数量。结果 30例患者均完成研究,三叶草法组和短轴平面内法组患者的年龄、性别、体质量比较差异均无统计学意义。两种方法所测得的腰丛深度差异无统计学意义(P>0.05);三叶草法组的图像定位时间显著短于短轴平面内法组[(35.9±20.1)s vs(53.7±21.2)s,P<0.01];三叶草法组的腰丛神经的超声成像评分明显高于短轴平面内法组[(2.8±0.4)分vs(2.1±0.8)分,P<0.01],三叶草法组的超声显像区域数量也明显大于短轴平面内法组(5.9±0.5 vs3.5±0.6,P<0.01)。结论采用超声引导下腰丛神经阻滞三叶草法的超声扫描显像效果优于短轴平面内法。Objective To investigate the efficacy of ultrasound guided Shamrock and short-axis in- plane methods in visualization of lumbar plexus block by comparing their accessibility, range and effect on ultrasonic imaging. Methods Thirty patients that underwent lumbar plexus block anesthesia for unilateral knee meniscus injury in our hospital from June to December 2015 were selected as study subjects. They were randomly and equally divided into 2 groups. The indexes, i.e. image positioning time, lumbar plexus depth, ultrasound visibility score （UVS） and ultrasonic imaging range, were recorded. Results All patients accomplished this study. There were no statistical differences between the 2 groups in the sex, age and weight. The difference of lumbar plexus depth between the 2 groups was not significant either. The positioning time of Shamrock group was shorter than that of short-axis in-plane group （35.9 ± 20. 1 vs 53.7 ±21.2 s, P 〈 0. 01 ）. For both the UVS and imaging range, Shamrock group was significantly higher than short-axis in-plane group （ P 〈 0.01 ）, with respective values of UVS （2.8 ± 0.4 vs 2.1 ± 0.8 points ） and range （ 5.9 ± 0. 5 vs 3.5± 0. 6 ）. Conclusion Shamrock method is superior to short-axis in-plane method in ultrasonic visualization of lumbar plexus block.

关 键 词：超声 腰丛神经阻滞 短轴平面内法 三叶草法 

分 类 号：R445.1[医药卫生—影像医学与核医学] R614.4[医药卫生—诊断学]