锁骨近端骨折切开复位内固定术神经阻滞麻醉方式的选择  

Selection of nerve block anesthesia for open reduction and internal fixation of proximal clavicle fracture

作　　者：陈永球 CHEN Yong-qiu(Changshu Affiliated Hospital of Nanjing University of traditional Chinese medicine(Changshu Hospital of traditional Chinese Medicine),Jiangsu Changshu 215500,China)

机构地区：[1]南京中医药大学常熟附属医院(常熟市中医医院),江苏常熟215500

出　　处：《临床医药文献电子杂志》2020年第94期1-2,共2页Electronic Journal of Clinical Medical Literature

摘　　要：目的对锁骨近端骨折接受切开复位内固定的患者,采用不同神经阻滞麻醉方式,分析其临床效果。方法将2017年6月—2020年6月我院收治的锁骨近端骨折患者纳为研究对象,随机法分为观察组和对照组,观察组采取臂丛神经联合颈浅丛神经阻滞麻醉,对照组采取臂丛神经阻滞麻醉。观察视觉模拟疼痛值、心率和平均动脉压等指标。结果共有46例患者纳入研究,每组23例,观察组的优良率为95.65%,好于对照组,有统计学显著性差异(P<0.05);与麻醉前相比,观察组麻醉30分钟后的心率和平均动脉压无明显变化(P>0.05);与对照组相比,观察组麻醉30分钟后的心率和平均动脉压低于对照组,有统计学显著性差异(P<0.05)。结论对锁骨内侧骨折的患者,在切开复位内固定手术中,采用臂丛联合颈浅丛神经阻滞麻醉的方式能够使患者获得较好的麻醉效果,从而保证手术安全,值得进一步推广。Objective to analyze the clinical effect of different nerve block anesthesia methods for patients with proximal clavicle fracture undergoing open reduction and internal fixation.Methods The patients in the observation group were randomly divided into the control group and the observation group.Visual analogue pain value,heart rate and mean arterial pressure were observed.Results a total of 46 patients were included in the study,23 cases in each group.The excellent and good rate of the observation group was 95.65%,which was better than that of the control group,with statistically significant difference(P<0.05);compared with before anesthesia,the heart rate and mean arterial pressure of the observation group after 30 minutes of anesthesia had no significant change(P>0.05);compared with the control group,the heart rate and mean arterial pressure of the observation group after 30 minutes of anesthesia were lower than those of the control group The difference was statistically significant(P<0.05).Conclusion for patients with medial clavicular fracture,brachial plexus combined with superficial cervical plexus block anesthesia can make patients obtain better anesthesia effect,so as to ensure the safety of operation,which is worthy of further promotion.

关 键 词：锁骨近端骨折 切开复位内固定术 臂丛神经阻滞麻醉 颈浅丛神经阻滞麻醉 

分 类 号：R683[医药卫生—骨科学]