臂丛阻滞(肌间沟、锁骨上入路)对呼吸功能的影响

Effect of Interscalene and Superclavical Brachial Plexus Blocks on Respiratory Function

目的 观察两种麻醉方法对患者呼吸功能的影响； 方法 用日本产ＭＩＣＲＯＳＰＩＲＯ－ ５０１ 型肺功能仪检测９ 例肌间沟入路和８ 例锁骨上入路臂丛神经阻滞患者麻醉前后的通气功能并做出统计学处理；结果 患者肺活量（ＶＣ）、用力肺活量（ＦＶＣ）、１ 秒钟时间肺活量（ＦＥＶ）均有显著下降（ Ｐ＜ ０．０５） ，其下降幅度与既往报道由于单侧膈肌麻痹所造成的通气降低幅度相近；结论 两种麻醉方法均可阻滞膈神经而导致单侧膈肌麻痹，引起通气功能下降，因此：（１）并发心肺疾患、呼吸代偿功能低下或有严重胸部损伤、呼吸功能不全者，慎行此两种神经阻滞。（２） 不宜同时对侧锁骨上和肌间沟阻滞。（３） 麻醉中慎用强力镇静药。

Objective To detect the effects of interscalene and superclavical brachial plexus block on respiratory function.Methods The respiratory function of 9 patinets anesthesized with interscalene brachial plexus block and that of eight patients with superclavical brachial plexus block were tested.Results The vital capacity(VC),force viatal capacity (FVC)and force expiratory volume(FEV) were reduced significantly(P<0.05). Conclusion Interscalene and superclavical brachial plexus blocks are safe to the normal patients but those suffering from serious lung and chest diseases.