超声引导下神经阻滞用于 锁骨骨折内固定手术的临床观察
李 俊 聂瑞霞 文立红 吴济宇
（广东省第二人民医院，广东 广州，510317）
中图分类号：R614.4 文献标识码：A 文章编号：1674-7860(2015)30-0095-03 证型：IBDG
【摘 要】目的：观察超声引导下神经阻滞麻醉用于锁骨骨折内固定手术的临床效果。方法：锁骨骨折内固定手术的患者60例，ASA为Ⅰ～Ⅱ级，随机分为两组，每组30例。A组采用传统打法，臂丛（肌间沟入路）联合颈浅丛神经阻滞；B组在高频超声引导下臂丛（肌间沟入路）联合颈浅丛神经阻滞。麻醉操作完成后15 min，采用针刺C3－C7神经支配区域方法测试麻醉效果及患者视觉模拟评分（VAS）。记录麻醉前10 min，麻醉后15 min，麻醉后30 min和麻醉后120 min的血压、心率和血氧饱和度。结果：B组的视觉模拟评分（VAS）是明显低于A组的（P＜0.05）；与A组相比，B组的生命体症也明显更平稳（P＜0.05）。结论：在锁骨骨折内固定手术中，超声引导下臂丛（肌间沟入路）联合颈浅丛神经阻滞效果明显优于传统神经阻滞。
【关键词】超声；神经阻滞；锁骨骨折
【Abstract】Objective: To observe the clinical effect of nerve block guided by ultrasound oninternal fixation of clavicle fractures. Methods:60 patients with internal fixationof clavicle fractures, ASA Ⅰ～Ⅱ level,were randomly divided into 2 groups（n=30）. A group took traditional anaesthesia, brachial plexus block（interscalene approach） associate with superficial cervical plexus block. B group took brachial plexus block（interscalene approach）guided byultrasound associate with superficialcervical plexus block. 15 minutes after anesthesia procedure, the effect ofanesthesia and patient’svisual analogue scale(VAS) was tested by the method of needling C3-C7 innervation region.Results: The visual analogue scale(VAS) of the B groupwas significantlylower than the A group(P<0.05). Comparedwith A group, vital signs of the B groupwere also significantlymore stable(P<0.05). Conclunsion: The effect of nerve block guided byultrasound（interscalene approach）associate with superficial cervical plexus block was significantlybetter.
【Keywords】Ultrasound; Nerve block;Broken Collarbone
doi:10.3969/j.issn.1674-7860.2015.30.045
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