颈丛阻滞下行颈动脉内膜剥脱术——附32例分析  

Carotid endarterectomy under cervical plexus block,clinical analysis of 32 cases

作　　者：朱宇麟[1] 景桂霞[1] 朱敦[1] 谭敬[1] 申新[1] 李小刚[1] 高燕凤[1] 

机构地区：[1]西安交通大学第一医院麻醉科,陕西西安710061

出　　处：《中国现代医学杂志》2004年第9期80-82,85,共4页China Journal of Modern Medicine

摘　　要：目的　观察颈丛阻滞下行颈动脉内膜剥脱术的效果。方法　 2 8名ASAⅡ～Ⅲ级患者行 32例颈动脉内膜剥脱术 ,采用深浅丛联合阻滞 ,观察围术期血液动力学指标变化 ,分流管放置率和并发症情况。结果　麻醉后血压和心率与麻醉前相比差异有显著性 (P <0 .0 5 ) ,其它时点与麻醉前相比差异无显著性 (P >0 .0 5 )。颈动脉夹闭前后收缩压和心率的波动性的差异无显著性 (P >0 .0 5 )。围术期高血压的发生率为 5 0 .0 % ,低血压 6 .2 5 % ,心动过速 2 8.1% ,心动过缓 6 .2 5 % ,分流管放置率 6 .2 5 %。患者满意率 84 .4 %。无 1例改用全麻 ,无严重围术期并发症。结论　颈丛阻滞是颈动脉内膜剥脱术安全、有效的麻醉方法。Objective:To observe the effect of carotid endarterectomy under cervical block.Methods: 28 ASA Ⅱ～Ⅲ patients accepted 32 cases of carotid endarterectomy under deep combined with superficial cervical block. Hemodynamic parameters and the rate of shunt performed and perioperative complications were observed.Results: Postanesthetic blood pressure and heart were different significantly from those of preanesthesia ( P <0.05) ,but there were no significant differences between other time points.There were no marked difference of SBP and HR fluctuation between pre- and post- carotid cross-clamping ( P > 0.05 ) .The incidence of hypertension was 50.0% ,hypotension 6.25% ,tachycardia 28.1% bradycardia perioperative 6.25% respectively. 6.25% Of patients was performed with shunting. 84.4% Of patients felt satisfied with their anesthesia. No patient converted to general anesthesia and no severe complication occurred during operation.Conclusions:Cervical block is a safe and effective method for carotid endarterectomy.

关 键 词：颈动脉内膜剥脱术 麻醉 颈丛阻滞 血液动力学 并发症 

分 类 号：R614.4[医药卫生—麻醉学]