超声引导喙突锁骨下入路和肌间沟入路臂丛神经阻滞在行上肢手术患者中的应用效果分析  

Analysis on Application Effect of Ultrasound-Guided Coracoid Process Subclavian Approach and Interscalene Approach for Brachial Plexus Block in Patients Undergoing Upper Limb Surgery

作　　者：潘丽霞 何文政[2] 冯丝丝 陈益凤 荣恒 Pan Lixia;He Wenzheng;Feng Sisi;Chen Yifeng;Rong Heng(Department of Anesthesiology,Maternity and Child Health Care of Guangxi Zhuang Autonomous Region1,Nanning 530002,Guangxi Zhuang Autonomous Region,China;Department of Anesthesiology,The First Affiliated Hospital of Guangxi Medical University2,Nanning 530021,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西壮族自治区妇幼保健院麻醉科,广西壮族自治区南宁530002 [2]广西医科大学第一附属医院麻醉科,广西壮族自治区南宁530021

出　　处：《中国社区医师》2024年第21期42-44,共3页Chinese Community Doctors

基　　金：广西壮族自治区卫生厅自筹经费科研项目(编号:Z2014029)。

摘　　要：目的:分析超声引导喙突锁骨下入路和肌间沟入路臂丛神经阻滞在行上肢手术患者中的应用效果。方法:选取2017年4月—2022年4月于广西医科大学第一附属医院拟在臂丛神经阻滞下行上肢手术的患者60例作为研究对象,按照随机双盲法分成观察组和对照组,各30例。观察组采用喙突锁骨下入路,对照组采用肌间沟入路臂丛神经阻滞,比较两组麻醉效果。结果:两组手术镇痛所需时间比较,差异无统计学意义(P>0.05);观察组进针次数和阻滞操作时间长于对照组,感觉阻滞持续时间短于对照组(P<0.05)。观察组尺神经、正中神经、前臂内侧皮神经及臂内侧皮神经的感觉阻滞起效时间均短于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:超声引导喙突锁骨下入路和肌间沟入路臂丛神经阻滞在行上肢手术患者的麻醉中均安全有效,临床应根据患者情况、手术部位及操作者的熟练程度选择不同的阻滞方法。Objective:To analyze the application effect of ultrasound-guided coracoid process subclavian approach and interscalene approach for brachial plexus block in patients undergoing upper limb surgery.Methods:From April 2017 to April2022,60 patients who were scheduled to undergo upper limb surgery under brachial plexus block in the First Affiliated Hospital of Guangxi Medical University were selected as the study subjects.They were divided into observation group and control group according to random double blind method,with 30 cases in each group.The observation group adopted coracoid process subclavian approach,and the control group adopted interscalene approach for brachial plexus block.The anesthetic effect of the two groups was compared.Results:There was no significant difference in the time required for surgical analgesia between the two groups(P>0.05).The number of needle insertions and the duration of block manipulation in the observation group were longer than those in the control group,while the duration of sensory block in the observation group was shorter than that in the control group(P<0.05).The onset time of sensory block of ulnar nerve,median nerve,medial antebrachial cutaneous nerve and medial brachial cutaneous nerve in the observation group was shorter than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ultrasound-guided coracoid process subclavian approach and interscalene approach for brachial plexus block are safe and effective in anesthesia of patients undergoing upper limb surgery,and different block methods should be selected in clinical setting according to the patient's condition,surgical site and operator's proficiency.

关 键 词：超声 臂丛神经阻滞 喙突锁骨下入路 肌间沟入路 上肢手术 

分 类 号：R614[医药卫生—麻醉学]