超声引导下臂丛神经阻滞在儿童上肢骨折手术中的应用效果  

Application effect of ultrasound-guided brachial plexus block in the surgery for upper limb fracture in children

作　　者：杜文康 林丽佳 成黎明[1] 李超[1] 张明[1] DU Wen-kang;LIN Li-jia;CHENG Li-ming;LI Chao;ZHANG Ming(Anesthesiology Department,Kunming Children's Hospital,Kunming 650228;Medical Department,the Third People's Hospital of Kunming,Kunming 650041,China)

机构地区：[1]昆明市儿童医院麻醉科,云南昆明650228 [2]昆明市第三人民医院医务科,云南昆明650041

出　　处：《临床医学研究与实践》2019年第22期20-21,共2页Clinical Research and Practice

基　　金：昆明市科技计划项目(No.2018-1-R-17197)

摘　　要：目的探讨超声引导下臂丛神经阻滞在儿童上肢骨折手术中应用效果及安全性。方法选择2018年7月至2019年2月在我院择期行上肢骨折切开复位内固定术的80例患儿为研究对象,采用随机数字表法将其分为超声组(C组)和盲探组(M组),每组40例。C组施行B超引导下臂丛神经阻滞,M组施行盲探臂丛神经阻滞。比较两组的麻醉效果。结果C组神经阻滞起效时间及PACU停留时间短于M组,镇痛持续时间长于M组(P<0.05)。C组麻醉效果明显优于M组,误入血管发生率、术后烦躁哭闹发生率及PAED评分均低于M组(P<0.05)。结论超声引导下臂丛神经阻滞在儿童上肢骨折手术中的应用效果显著,可以明显提高麻醉效果,且安全性高,在临床有较大的应用价值。Objective To investigate the application effect and safety of ultrasound-guided brachial plexus block in the surgery for upper limb fracture in children.Methods Eighty children who underwent open reduction and internal fixation of upper limb fracture from July 2018 to February 2019 were selected as the study objects.The children were divided into ultrasound group(group C)and blind exploration group(group M)by random number table method,with 40 cases in each group.The group C was given with ultrasound-guided brachial plexus block,and the group M was given blind exploration of brachial plexus block.Anesthesia effects were compared between the two groups.Results The onset time of nerve block and the residence time of PACU in the group C were shorter than those in the group M,and the duration of analgesia was longer than that in the group M(P<0.05).The anesthesia effect of the group C was better than that of the group M,and the incidences of misentry into blood vessels,postoperative restlessness and crying and the PAED score were lower than those of the group M(P<0.05).Conclusion Ultrasound-guided brachial plexus block has a significant effect in the surgery for upper limb fracture in children.It can significantly improve the anesthetic effect high safety,which has high safety and great application value in clinic.

关 键 词：超声 臂丛神经阻滞 麻醉 上肢骨折 

分 类 号：R726.1[医药卫生—儿科]