超声引导神经根阻滞在老年患者肩关节脱位手法复位中的应用效果  

Effect of ultrasound-guided nerve roots block on manual reduction of shoulder dislocation in senile patients

作　　者：王琦 何靖 WANG Qi;HE Jing(Anesthesiology Department,Jiangning Hospital Affiliated to Nanjing MedicalUniversity,Nanjing,Jiangsu,211100)

机构地区：[1]南京医科大学附属江宁医院麻醉科,江苏南京211100

出　　处：《实用临床医药杂志》2018年第15期67-69,共3页Journal of Clinical Medicine in Practice

摘　　要：目的观察超声引导C_5、C_6神经根阻滞在老年患者肩关节脱位手法复位中的应用效果。方法选择80例急诊行肩关节脱位手法复位的老年患者,随机分为超声引导组(U组)和传统方法定位组(C组)各40例。U组为高频超声引导下行C_5和C_6神经根阻滞,C组为臂丛(肌间沟入路)神经阻滞。观察2组麻醉起效时间、感觉阻滞完善时间、麻醉效果、膈肌麻痹程度,记录不良反应以及患者对麻醉效果的满意度。结果 U组麻醉完成时间、感觉阻滞起效时间和感觉阻滞完善时间显著短于C组(P<0.05),U组完全性膈肌麻痹的发生率显著低于C组(P<0.05),U组麻醉效果显著优于C组(P<0.05)。结论超声引导C_5和C_6神经根阻滞可缩短麻醉起效时间,为肩关节脱位手法复位提供良好的麻醉效果,不良反应较少。Objective To observe Effect of ultrasound-guided C 5-6 nerve roots block in manual reduction of shoulder dislocation in senile patients. Methods A total of 80 senile patients with shoulder dislocation underwent manual reduction were randomly and evenly divided into ultrasound-guided group（group U） and conventional location group（group C）. Group U（ n =40） took C 5-6 nerve roots block guided by ultrasound, while group C（ n =40） took traditional anaesthesia, interscalene brachial plexus block. The onset time of anesthesia, completed time of sensory block, diaphragmatic anesthesia degree were compared, adverse reactions and comprehensive satisfaction to anesthesia were observed and compared. Results Group U had obviously shorter onset time of anesthesia block, the completed time of anesthesia, completed time of sensory block than that in group C （ P 〈0.05） . Compared with group C, the rate of diaphragmatic paralysis in group U was significantly lower （ P 〈 0.05） . The anesthesia effect of group U was better （ P 〈0.05）. Conclusion Ultrasound-guided C 5-6 nerve roots block can shorten anesthesia time, and strengthen anesthesia efficacy for manual reduction of shoulder joint dislocation, and reduce adverse reactions.

关 键 词：超声 神经根 老年患者 肩关节脱位 手法复位 

分 类 号：R274.21[医药卫生—中医骨伤科学]