两种神经阻滞方法用于锁骨骨折手术的临床观察

Nerve block for the two methods of clinical observation of clavicle fracture

目的:观察两种神经阻滞方法用于锁骨骨折手术的临床效果。方法:40例锁骨骨折切开复位内固定术患者随机平分为臂丛麻醉组(对照组)和颈丛+臂丛麻醉组(观察组)各20例,对比分析两组麻醉效果、对机体的影响与不良反应情况。结果:两组术前心率(HR)、平均动脉压(MAP)相比差异无统计学意义(P<0.05)。在阻滞中,组两组术中与术前相比,MAP和HR明显升高(P<0.05);同时对照组较观察组升高显著(P<0.05)。观察组20例,优12例,良6例,差2例,优良率为90.0%;对照组20例,优10例,良3例,差7例,优良率为65.0%。观察组的麻醉优良率明显好于对照组(P<0.05)。两组不良反应情况都比较轻微,对比差异无统计学意义(P>0.05)。结论:臂丛颈丛联合阻滞的效果完善,损伤小,易掌握,不易发生局麻药中毒反应,在锁骨骨折手术临床上是一种经济、实用的麻醉方法。

Objective： To observe the two nerve block methods for the clinical effect of clavicle fracture surgery.Methods： 40 cases of clavicle fractures with open reduction and internal fixation of brachial plexus anesthesia were randomly divided into groups（control group） and cervical plexus＋brachial plexus anesthesia group（observation group）,compared two groups of effects of anesthesia,and adverse effects on the body reactions.Results： Preoperatively both groups HR,mean arterial pressure（MAP） compared with no significant difference.Group compared with the preoperative surgery,MAP and HR increased significantly（P〈0.05）;group compared with the control group patients increased significantly compared with the observation group（P〈0.05）.Observation group,20 patients were excellent in 12 cases,good in 6 and poor in 2 cases,the fine rate was 90.0%;control group,20 patients were excellent in 10 cases,good in 3 and poor in 7 cases,good rate of 65.0%.The observation group was significantly better quality of anesthesia in the control group（P〈0.05）.The two groups are relatively minor adverse reactions,no significant difference in contrast（P〉0.05）.Conclusion： The brachial plexus block cervical plexus combined effect of improved,less damage,easy to grasp,less prone to toxic reactions of local anesthetics in surgery for clavicle fracture is an economical and practical method of anesthesia.