盐酸罂粟碱注射液经连续腋路臂丛神经阻滞途径在断指再植患者中的应用效果  

The Effect of Papaverine Hydrochloride Injection through Continuous Axillary Brachial Plexus Nerve Block in Patients with Severed Finger Replantation

作　　者：陈本法 张广蒙 马玉峰 李玉见 邱彦明 翁洪亮 张雷 李兴达 CHEN Benfa;ZHANG Guangmeng;MA Yufeng;LI Yujian;QIU Yanming;WENG Hongliang;ZHANG Lei;LI Xingda(Department of Anesthesiology,Linyi Central Hospital,Yishui 276400,China)

机构地区：[1]临沂市中心医院麻醉科,山东沂水276400 [2]山东第二医科大学附属医院麻醉科,山东潍坊261000

出　　处：《中国医学创新》2025年第7期5-10,共6页Medical Innovation of China

基　　金：山东省医学会临床科研专项资金项目(YXH2021ZX032);吴阶平医学基金会临床科研专项资助基金项目(320.6750.2024-15-33)。

摘　　要：目的:观察盐酸罂粟碱注射液不同给药途径在断指再植手术患者中的临床应用效果。方法:选取临沂市中心医院2023年1—12月手足外科的60例急诊行单指离断指再植的患者作为本次研究对象,采用随机数字表法分为观察组和对照组,每组30例。观察组给予盐酸罂粟碱注射液,采用连续腋路臂丛神经阻滞途径,对照组给予盐酸罂粟碱注射液,采用肌肉注射途径。专人负责连续观察并记录,记录内容包括两组断指再植指术后2、4、8、12、16、24、36、48 h再植指毛细血管充盈程度、末梢皮肤温度、末梢皮肤颜色,以及血管危象和1周的成活率,并记录断指再植手术后不良反应发生情况。结果:观察组术后2、4、8、12、16、24、36、48 h再植指毛细血管充盈程度、末梢皮肤温度及末梢皮肤颜色均优于对照组(P<0.05);观察组血管危象发生率低于对照组(P<0.05);观察组断肢再植成活率高于对照组(P<0.05);对照组皮肤瘙痒、便秘等不良反应发生率均高于观察组(P<0.05)。结论:盐酸罂粟碱注射液经连续腋路臂丛神经阻滞途径给予能减少全身不良反应发生率,还能够持续有效地发挥扩血管作用,减少再植指血管危象的发生,提高再植指的成活率。Objective:To observe the clinical effects of different administration routes of Papaverine Hydrochloride Injection in patients with severed finger replantation surgery.Method:Sixty patients who underwent emergency single finger severed finger replantation in the Department of Hand-foot Surgery in Linyi Central Hospital from January to December 2023 were selected as the observation objects of this study.By using random number table method,patients were randomly divided into observation group and control group,with 30 patients in each group.Observation group was given Papaverine Hydrochloride Injection by continuous axillary brachial plexus nerve block,control group was given Papaverine Hydrochloride Injection by intramuscular injection.A special person was responsible for continuous observation and recording,the degree of capillary filling,terminal skin temperature,terminal skin color at 2,4,8,12,16,24,36 and 48 hours after replantation of the finger,vascular crisis,and 1 week survival rate were recorded in the two groups.The adverse reactions after replantation were also recorded.Result:At 2,4,8,12,16,24,36 and 48 hours,the degree of capillary filling,terminal skin temperature,terminal skin color of the observation group were better than those of the control group(P<0.05).The rate of vascular crisis in observation group was lower than that in control group(P<0.05).The survival rate of severed finger replantation in observation group was higher than that in control group(P<0.05).The incidence of skin pruritus,constipation and other adverse reactions in control group were higher than those in observation group(P<0.05).Conclusion:Papaverine Hydrochloride Injection through continuous axillary brachial plexus nerve block can reduce systemic adverse reactions,but also can continuously and effectively play the role of vasodilator,reduce the occurrence of vascular crisis of retransplanted finger,and improve the survival rate of retransplanted finger.

关 键 词：盐酸罂粟碱注射液 连续腋路臂丛神经阻滞 断指再植 

分 类 号：R614[医药卫生—麻醉学]