探讨臂丛神经阻滞麻醉在B超引导下的临床效果  

Clinical Effect of Brachial Plexus Block Anesthesia Guided by B-ultrasound

作　　者：张桂菊 李玉显 胜海峰 ZHANG Guiju;LI Yuxian;SHENG Haifeng(Department of Anesthesiology,Chengwu County People's Hospital,Heze,Shandong Province,274200 China)

机构地区：[1]成武县人民医院麻醉科,山东菏泽274200

出　　处：《中外医疗》2024年第10期34-38,共5页China & Foreign Medical Treatment

摘　　要：目的探究B超引导下臂丛神经阻滞麻醉的效果。方法随机选取2021年7月—2023年7月成武县人民医院收治的100例实施麻醉的上肢骨折手术患者为研究对象,以随机数表法分成参照组与研究组,各50例。参照组采取肌间沟臂丛神经阻滞麻醉,研究组采取B超引导下臂丛神经阻滞麻醉。比较两组患者的临床镇静评分(Ramsay Sedation Scale,Ramsay)、阻滞起效时间、完全阻滞时间、神经阻滞程度、镇痛维持时间、阻滞消退时间、循环系统功能以及不良反应发生情况。结果研究组患者的Ramsay评分、血氧饱和度(Oxygen Saturation,SpO_(2))水平、镇痛维持时间优于参照组,差异有统计学意义(P均<0.05);研究组阻滞起效时间、完全阻滞时间、舒张压(Diastolic Blood Pressure,DBP)及心率(Heart Rate,HR)水平、阻滞消退时间均优于参照组,差异有统计学意义(P均<0.05)。研究组患者的神经阻滞程度Ⅰ级高于参照组,神经阻滞程度Ⅱ级与Ⅲ级均低于参照组,差异有统计学意义(P<0.05);研究组患者的不良反应总发生率为2.00%,低于参照组的16.00%,差异有统计学意义(χ^(2)=4.396,P<0.05)。结论B超引导下的臂丛神经阻滞麻醉在手术中的应用具有高度的精准性、安全性和可控性,为医生提供了更可靠的术中引导,同时也减少了辐射暴露的风险。Objective To explore the effect of brachial plexus block anesthesia guided by B-ultrasound.Methods A total of 100 patients undergoing anesthesia for upper limb fracture surgery admitted to Chengwu County People's Hospital from July 2021 to July 2023 were randomly selected as the study objects,and they were divided into the reference group and the study group by random number table method,with 50 cases in each group.The reference group received brachial plexus block anesthesia,and the study group received brachial plexus block anesthesia guided by B-ultrasound.The clinical Ramsay Sedation Scale(Ramsay),onset time of block,complete block time,nerve block degree,analgesic maintenance time,block resolution time,circulatory system function and the occurrence of adverse reactions were compared between the two groups.Results Ramsay score,oxygen saturation(SpO_(2))level and analgesia maintenance time in study group were better than those in reference group,and the differences were statistically significant(all P<0.05).The onset time of block,complete block time,diastolic blood pressure(DBP),heart rate(HR)and block resolution time of the study group were better than those of the reference group,and the differences were statistically significant(all P<0.05).The degree of nerve block in grade Ⅰ was higher than that in the reference group,and the degree of nerve block in grade Ⅱ and grade Ⅲ was lower than that in the reference group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was 2.00%,lower than that in the reference group(16.00%),and the difference was statistically significant(χ^(2)=4.396,P<0.05).Conclusion The application of brachial plexus block anesthesia guided by B-ultrasound in surgery has a high degree of accuracy,safety and controllability,which provides doctors with more reliable intraoperative guidance and reduces the risk of radiation exposure.

关 键 词：上肢手术 麻醉 B超 臂丛神经阻滞 不良反应 

分 类 号：R614[医药卫生—麻醉学]