超声联合神经刺激仪双引导下臂丛神经阻滞对断指再植术患者的影响  

Effect of Brachial Plexus Block under Double Guidance of Ultrasound and Nerve Stimulator on Patients Undergoing Replantation of Amputated Finger

作　　者：王玉秀 祁宾[2] 丁新照 WANG Yuxiu;QI Bin;DING Xinzhao(Huai’an No.82 Hospital,Huai’an 223001,China;不详)

机构地区：[1]淮安八十二医院,江苏淮安223001 [2]南京医科大学附属淮安第一医院

出　　处：《中外医学研究》2023年第12期15-19,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探究超声联合神经刺激仪双引导下臂丛神经阻滞对断指再植术患者的影响。方法:选取2019年1月—2020年12月淮安八十二医院收治的112例行断指再植术的患者作为本次研究对象。根据随机数表法将其分为对照组及研究组,各56例。对照组给予神经刺激仪引导下臂丛神经阻滞,研究组给予超声联合神经刺激仪双引导下臂丛神经阻滞。比较两组穿刺情况,阻滞情况,术后1 d、3 d、5 d手指灌注情况,再植手指成活率,术前、术后24 h应激指标及不良反应。结果:研究组穿刺所用时间短于对照组,穿刺后视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05)。研究组阻滞起效时间、完全神经阻滞时间、感觉神经完全阻滞时间、运动神经完全阻滞时间均显著短于对照组,差异有统计学意义(P<0.05)。术后3 d、5 d,两组手指灌注情况评分均高于术后1 d,术后5 d高于术后3 d,研究组手指灌注情况评分均明显高于对照组,差异有统计学意义(P<0.05)。研究组再植手指成活率显著高于对照组,差异有统计学意义(P<0.05)。术后24 h,两组肾上腺素(adrenaline,A)、去甲肾上腺素(norepinephrine,NE)水平均较术前升高,但研究组A、NE水平均低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:超声联合神经刺激仪双引导下臂丛神经阻滞能有效减轻应激反应,同时改善患者断指再植术后手指组织灌注情况,提升再植手指成活率。Objective:To explore the effect of brachial plexus block under double guidance of ultrasound and nerve stimulator on patients undergoing replantation of amputated finger.Method:From January 2019 to December 2020,112 patients who underwent replantation of amputated finger in Huai’an No.82 Hospital were selected as the subjects of this study.According to the random number method,they were divided into the control group and the study group,56 cases in each group.The control group was given brachial plexus block guided by nerve stimulator,and the study group was given brachial plexus block guided by ultrasound combined with nerve stimulator.The puncture condition,block condition,finger perfusion condition at 1 day,3 days and 5 days after operation,the survival rate of replantation fingers,stress indexes before and 24 h after operation and adverse reactions were compared between the two groups.Result:The puncture time of the study group was shorter than that of the control group,and the visual analogue scale(VAS)score after puncture was lower than that of the control group,and the differences were statistically significant(P<0.05).The block onset time,complete nerve block time,complete sensory nerve block time and complete motor nerve block time in the study group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).The finger perfusion condition scores of the two groups at 3 d and 5 d after operation were higher than those at 1 d after operation,5 d after operation were higher than those at 3 d after operation,and the finger perfusion condition scores of the study group were significantly higher than those of the control group,the differences were statistically significant(P<0.05).The survival rate of replanted fingers in the study group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).At 24 h after operation,the levels of adrenaline(A)and norepinephrine(NE)in the two groups were higher t

关 键 词：断指再植术 超声 神经刺激仪 臂丛神经阻滞 组织灌注 血清应激指标 

分 类 号：R658.1[医药卫生—外科学]