肾上腺素联合利多卡因在锁骨骨折内固定术中的应用效果  

Application effects of epinephrine combined with lidocaine in internal fixation operation of clavicle fracture

作　　者：王刚[1] 白晓冬[1] 刘振宇[1] 许国强 陈文韬[1] 王宝军[1] WANG Gang;BAI Xiaodong;LIU Zhenyu;XU Guoqiang;CHEN Wentao;WANG Baojun(Department of Orthopedics,Affiliated Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《重庆医学》2021年第15期2630-2633,共4页Chongqing medicine

摘　　要：目的探讨肾上腺素联合利多卡因在锁骨骨折内固定术中的应用效果。方法选取2017年3月至2019年10月该院住院收治的117例锁骨骨折患者进行前瞻性研究,按随机数字表法分为3组:对照组52例,试验组Ⅰ37例,试验组Ⅱ28例。其中对照组手术切皮前无特殊处理;试验组Ⅰ手术切皮前切口周围局部注射利多卡因0.1 g;试验组Ⅱ手术切皮前切口周围局部注射利多卡因0.1 g,同时配以1∶10万盐酸肾上腺素。分析各组术中总出血量、手术时间、术后疼痛程度[视觉模拟量表(VAS)评分],以及术后有无因伤口周围红肿、渗液较多而影响拆线时间等情况发生。结果试验组Ⅱ的总出血量[(32.32±3.11)mL]、手术时间[(55.99±7.07)min]均小于试验组Ⅰ[(48.58±5.61)mL、(66.86±10.28)min]和对照组[(51.02±5.94)mL、(68.03±8.20)min],差异均有统计学意义(P<0.001);试验组ⅡVAS评分[(3.97±1.11)分]与试验组Ⅰ[(4.18±0.82)分]比较,差异无统计学意义(P=0.449),与对照组[(6.26±1.53)分]有明显差异(P<0.001)。3组术后均存在因伤口周围红肿、渗液较多而影响拆线时间的情况,差异无统计学意义(P>0.05)。结论锁骨骨折内固定术中应用1∶10万肾上腺素联合利多卡因的止血效果显著,且能明显缩短手术时间。Objective To investigate the application effects of epinephrine combined with lidocaine in the internal fixation operation of clavicle fracture.Methods A total of 117 cases of clavicle fracture in this hospital from March 2017 to October 2019 were selected to conduct the prospective study and divided into 3 groups according to the random number table method,52 cases in the control group,37 cases in the experimental groupⅠand 28 cases in the experimental groupⅡ.The control group had no special treatment before skin incision;the experimental groupⅠwas locally injected by 0.1 g lidocaine around the incision before surgery;the experimental groupⅡwas locally injected by 0.1 g lidocaine around the incision before surgery,meanwhile matched with 1∶100000 epinephrine.The amount of total bleeding,operation time,postoperative pain degree(visual analogues scale,VAS),and whether the time of stitch removal was affected by redness and much exudation around the wound in each group were analyzed.Results The amount of total bleeding[(32.32±3.11)mL]and the operation time[(55.99±7.07)min]of the experimental groupⅡwere significantly less than those of the experimental groupⅠ[(48.58±5.61)mL,(66.86±10.28)min]and the control group[(51.02±5.94)mL,(68.03±8.20)min],and there were statistically significant differences(P<0.001).There was no statistically significant difference in the postoperative VAS score between the experimental groupⅡ[(3.97±1.11)points]and experimental groupⅠ[(4.18±0.82)points,P=0.449],compared with the control group[(6.26±1.53)points],and the difference was statistically significant(P<0.001).The stitches removal delay due to redness and much exudation around the wound existed in all three groups,and the difference was not statistically significant(P>0.05).Conclusion The combination of 1∶100000 epinephrine and lidocaine has significant hemostatic effect in the internal fixation operation of clavicle fracture,moreover can significantly shorten the operation time.

关 键 词：麻醉 肾上腺素 利多卡因 骨折固定术 止血 疼痛测定 

分 类 号：R687.3[医药卫生—骨科学]