超声引导下颈丛联合臂丛神经阻滞在老年锁骨骨折内固定术中的应用效果  

Application effect of ultrasound-guided cervical plexus combined with brachial plexus block in internal fixation of elderly clavicle fracture

作　　者：欧阳新红 黄其飞 邓拓荒 OUYANG Xinhong;HUANG Qifei;DENG Tuohuang(Department of Anesthesiology,Linchuan District People's Hospital,Fuzhou,Jiangxi,344000,China)

机构地区：[1]临川区人民医院麻醉科,江西抚州344000

出　　处：《当代医学》2024年第23期30-34,共5页Contemporary Medicine

摘　　要：目的探讨超声引导下颈丛联合臂丛神经阻滞在老年锁骨骨折内固定术中的应用效果。方法选取2019年9月至2021年10月于临川区人民医院行内固定术的68例锁骨骨折老年患者作为研究对象,随机分为对照组与观察组,各34例。对照组给予超声引导下肌间沟臂丛神经阻滞,观察组给予超声引导下颈丛联合臂丛神经阻滞。比较两组麻醉效果,神经阻滞效果,围手术期心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)、经皮动脉血氧饱和度(percutaneous arterial oxygen saturation,SpO2)水平,肌力恢复情况和不良反应发生率。结果观察组麻醉优良率为94.11%,高于对照组的76.47%,差异有统计学意义(P<0.05)。观察组感觉阻滞起效、运动阻滞起效时间均短于对照组,镇痛维持、运动阻滞维持时间均长于对照组,差异有统计学意义(P<0.05)。两组麻醉前、麻醉后15 min、内固定时、术毕时HR、MAP、SpO2水平组间比较差异无统计学意义。术后2、6、12 h,观察组肌力级数均高于对照组,差异有统计学意义(P<0.05);两组术后24 h肌力恢复级数比较差异无统计学意义。观察组不良发应发生率为2.94%,低于对照组的23.53%,差异有统计学意义(P<0.05)。结论超声引导下颈丛联合臂丛神经阻滞应用于老年锁骨骨折内固定术患者中,有利于增强阻滞效果,且血流动力学和肌力水平较稳定,不良反应发生率低,值得临床推广应用。Objective To explore the application effect of ultrasound-guided cervical plexus combined with brachial plexus block in internal fixation of elderly clavicle fracture.Methods 68 elderly patients with clavicle fracture who underwent internal fixation in Linchuan District People's Hospital from September 2019 to October 2021 were selected as the study subjects,and they were randomly divided into the control group and the observation group,with 34 cases in each group.The control group was given ultrasound-guided interscalene brachial plexus block,and the observation group was given ultrasound-guided cervical plexus combined with brachial plexus block.The anesthesia effect,nerve block effect,perioperative heart rate(HR),mean arterial pressure(MAP),percutaneous arterial oxygen saturation(SpO2),muscle strength recovery and incidence of adverse reactions were compared between the two groups.Results The excellent and good rate of anesthesia in the observation group was 94.11%,which was higher than 76.47%in the control group,and the difference was statistically significant(P<0.05).The onset time of sensory block and motor block in the observation group were shorter than those in the control group,and the duration of analgesia and motor block were longer than those in the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in HR,MAP,and SpO2 levels between the two groups at before anesthesia,15 min after anesthesia,the time of internal fixation and the end of operation.At 2,6 and 12 h after operation,the muscle strength grades in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in the comparison of muscle strength recovery grades at 24 h after operation between the two groups.The incidence of adverse reactions in the observation group was 2.94%,which was lower than 23.53%in the control group,and the difference was statistically

关 键 词：锁骨骨折 内固定术 超声引导 臂丛神经阻滞 

分 类 号：R68[医药卫生—骨科学]