摘要
目的评价改良两入路臂丛神经阻滞用于肘以下手术的安全性和有效性.方法将100名前臂和手部手术的患者随机分为S组(单针组)和D组(改良两入路组),每组50例,S组用7号针头进行腋路臂丛神经阻滞,D组用7号针头和22G套管针分别在腋动脉上、下两侧进行臂丛神经阻滞.麻醉30 min后评价感觉和运动阻滞情况,观察局麻药中毒、血管神经损伤等麻醉并发症.结果臂丛神经前臂5分支感觉阻滞情况,单支比较,D组桡神经、肌皮神经阻滞的成功率高于S组(P<0.05),其他3支神经两组间比较差异无统计学意义(P>0.05),5支比较,D组高于S组(P<0.01);臂丛神经前臂4分支运动阻滞评估,D组桡神经、肌皮神经评分高于S组,差异有统计学意义(P<0.05),正中神经、尺神经两组间比较差异无统计学意义(P>0.05);麻醉并发症两组间比较差异无统计学意义(P>0.05).结论改良法两入路臂丛神经阻滞具有作用完善、并发症少等优点,值得临床借鉴和推广.
Objective To evaluate the efficacy and safety of the single and double injection techniques for axmary brachial plexus block.Methods The selected 100 patients who were operated on the antebrachium and hand were randomly divided into two groups：S group（single injection）and D group（double injection）,and 50 cases in each groups.In S group,axmary brachial plexus block was performed respectively with 7-gauge needle,and in D group,axmary brachial plexus block over the arillary artery and below the arillary artery was performed respectively with 7-gauge needle and 22-gauge sheath needle.30 minutes later after the injection,the sensory and motor function was evaluated,and the toxic reactions,vascular damage and other complications were observed.Results The 5 branches of the brachial plexus nerve in antebrachium showed sensory block.The success rate of D group was higher than that of S group in blocking the musculospiral nerve and perforans gasseri（P0.05）,the other three branch nerves between the two groups showed no statistical significance（P0.05）.However D group significantly more effective than S group in the overall blocking of the 5 banches of nerves（P0.01）.A comparison of motor block between the two groups：The score of D group was also higher than that of S group in blocking the musculospiral nerve and perforans gasseri（P0.05）.The difference of nervi medianus and cubital nerve between the two groups showed no statistical significance（P0.05）.For anesthesia complication,there was no statistically significant difference between the two groups（P0.01）.Conclusion Double injection technique is significantly more effective,more complete blocking and has less complication than single injection technique,and is worthy of clinically use and promotion.
出处
《昆明医学院学报》
2011年第8期117-120,共4页
Journal of Kunming Medical College
关键词
臂丛阻滞
单点法
两入路法
Brachial plexus block
Single injection
Double injection
作者简介
[作者简介]班崇云（1965～），男，广西钦州市人，医学本科，主治医师，主要从事临床麻醉工作．
