超声引导下肌间沟联合腋路臂丛神经阻滞用于上肢骨折手术的临床效果  

Clinical Effect of Ultrasound-guided Intermuscular Groove Combined with Axillary Brachial Plexus Block for Upper Limb Fracture Surgery

作　　者：杨涛 周颖 黎炎华 YANG Tao;ZHOU Ying;LI Yanhua(Yangjiang Jianghua Hospital,Yangjiang 529500,China;不详)

机构地区：[1]阳江江华医院,广东阳江529500

出　　处：《中外医学研究》2023年第28期63-66,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨超声引导下肌间沟联合腋路臂丛神经阻滞用于上肢骨折手术的临床效果。方法:选择2021年4月—2022年12月阳江江华医院收治的120例上肢骨折手术患者为研究对象,随机分为对照组与观察组,各60例。对照组开展解剖定位下肌间沟臂丛神经阻滞,观察组采用超声引导下肌间沟联合腋路臂丛神经阻滞。比较两组穿刺操作时间、30 min内痛觉阻滞效应、运动阻滞程度,记录比较两组术后2 h、6 h、12 h、24 h的视觉模拟评分法(VAS)评分及术后24 h内自控镇痛泵有效按压次数,比较两组术后24 h、48 h Ramsay镇静评分及患肢肌力、浅感觉、不良反应发生情况。结果:观察组穿刺操作时间短于对照组,30 min内痛觉阻滞效应与运动阻滞程度优于对照组,差异有统计学意义(P<0.05)。观察组术后2 h、6 h、12 h、24 h VAS评分均低于对照组,术后24 h内自控镇痛泵有效按压次数少于对照组,差异有统计学意义(P<0.05)。两组术后24 h、48 h Ramsay镇静评分及肌力异常、浅感觉异常患者占比比较,差异无统计学意义(P>0.05)。两组术后不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下肌间沟联合腋路臂丛神经阻滞用于上肢骨折手术效果显著,可缩短穿刺操作时间,增强阻滞效果,降低术后疼痛程度,且不增加不良反应,安全性高。Objective:To investigate the clinical effect of ultrasound-guided intermuscular groove combined with axillary brachial plexus block for upper limb fracture surgery.Method:A total of 120 patients with upper limb fracture surgery admitted to the Yangjiang Jianghua Hospital from April 2021 to December 2022 were selected as the study objects,and they were randomly divided into control group and observation group,with 60 cases in each group.The control group underwent anatomic location of axillary brachial plexus block,and the observation group underwent ultrasound-guided intermuscular groove combined axillary brachial plexus block.The puncture operation time,pain block effect within 30 min and motor block degree were compared between the two groups;the visual analogue scale(VAS)score at 2 h,6 h,12 h and 24 h after surgery,and the number of effective compressions of self-controlled analgesia pump within 24 h after surgery were recorded and compared between the two groups;the ramsay sedation score at 24 h and 48 h after surgery,muscle strength,superficial sensation and adverse reactions were compared between the two groups.Result:The puncture operation time in the observation group was shorter than that in the control group,and the pain block effect within 30 min and motor block degree were better than those in the control group,the differences were statistically significant(P<0.05).The VAS score at 2 h,6 h,12 h and 24 h after surgery of the observation group were lower than those of the control group,and the number of effective compressions of the self-controlled analgesia pump within 24 h after surgery was less than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences in Ramsay sedation score at 24 h and 48 h after surgery and the proportion of patients with abnormal muscle strength and shallow paresthesia between the two groups(P>0.05).There was no significant difference in the incidence of postoperative adverse reactions between the two groups(P>0.05

关 键 词：超声 肌间沟入路 腋路 罗哌卡因 臂丛神经阻滞 上肢骨折 

分 类 号：R687.3[医药卫生—骨科学]