超声引导下臂丛联合颈浅丛阻滞在锁骨骨折内固定术麻醉中的效果观察  

The anesthesia efficiency of ultrasound-guided brachial plexus combined with superficial cervical plexus block for the internal fixation of clavicle fracture

作　　者：王春斐 胡维维 刘鑫 Wang Chunfei;HuWeiwei;Liu Xin(Department of Anesthesiology,Dunhuang Hospital,Gansu Province,Dunhuang,Gansu,736200,China)

机构地区：[1]甘肃省敦煌市医院手术麻醉科,甘肃敦煌736200

出　　处：《当代医学》2020年第33期91-93,共3页Contemporary Medicine

摘　　要：目的探究超声引导下臂丛联合颈浅丛阻滞应用于锁骨骨折内固定术的麻醉效果。方法选取本院2015年7月至2018年7月收治的锁骨骨折患者70例作为研究对象,随机数表法分为对照组与观察组,每组35例。对照组行超声引导下单纯颈丛阻滞麻醉,观察组行超声引导下臂丛联合颈浅丛阻滞。比较两组麻醉效果及并发症情况。结果观察组临床总有疗效率(85.71%)明显高于对照组(62.86%),组间差异有统计学意义(P<0.05)。观察组霍纳综合症(2.85%)、膈神经阻滞(0.00%)以及喉返神经阻滞发生率(2.85%)与对照组(5.71%、5.71%及0.00%)比较差异无统计学意义。观察组患者心率(97.34±10.23)次/min低于对照组的(103.54±10.50)次/min,差异有统计学意义(P<0.05);观察组平均动脉压水平(88.01±10.23)mmHg低于对照组的(98.67±10.56)mmHg,差异有统计学意义(P<0.05);两组患者血氧饱和度水平比较差异无统计学意义。结论超声引导下臂丛联合颈浅丛阻滞应用于锁骨骨折麻醉效果显著,且未增加霍纳综合症等并发症的发生率,手术舒适度较高,值得推广。Objective To explore the anesthesia efficiency of ultrasound-guided brachial plexus combined with superficial cervical plexus block for the internal fixation of clavicle fracture.Methods 70 patients with clavicle fractures who were admitted to our hospital from July 2015 to July 2018 were selected as study subjects.They were divided into the control group and the observation group according to random number table method,with 35 cases in each group.The control group underwent ultrasound-guided simple cervical plexus block anesthesia,and the observation group underwent ultrasound-guided brachial plexus combined with superficial cervical plexus block.The anesthesia effect and complications were compared between the two groups.Results The total clinical efficacy(85.71%)of the observation group was significantly higher than 62.86% of the control group,the difference was statistically significant between two groups(P<0.05).There was no significant difference in the incidence of Horner syndrome(2.85%),phrenic nerve block(0.00%)and recurrent laryngeal nerve block(2.85%)between the observation group and the control group(5.71%,5.71% and 0.00%),there was no statistical difference between two groups.The heart rate of the observation group(97.34±10.23)times/min was lower than that of the control group(103.54±10.50)times/min,and the difference was significant between two groups(P<0.05).The average arterial pressure level of the observation group was(88.01±10.23)mmHg which was lower than that(98.67±10.56)mmHg in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in blood oxygen saturation between the two groups.Conclusion Ultrasound-guided brachial plexus combined with superficial plexus block can effectively improve the anesthesia effect in the internal fixation of clavicular fracture,without increasing the relative morbidity such as recurrent laryngeal nerve block.And it also allows a higher surgical comfort,which is worth promoting.

关 键 词：锁骨骨折 麻醉 超声 颈浅丛阻滞 

分 类 号：R614[医药卫生—麻醉学]