腕部神经阻滞麻醉与肌间沟臂丛麻醉治疗腕横纹以远手外伤的疗效比较

Comparison of Wrist Nerve Block and Interscalene Brachial Plexus Block for Hand Injury Distal to Wrist Crease

目的比较应用腕部神经阻滞麻醉与肌间沟臂丛麻醉治疗腕横纹以远手外伤的临床效果。方法将腕横纹以远手外伤患者59例随机分为2组：A组28例采用腕部神经阻滞方法,B组31例采用肌间沟臂丛麻醉方法。比较2组麻醉起效时间、麻醉效果满意度及术中相关并发症发生情况。结果 A组麻醉起效时间为（2.06±1.08）min,B组为（20.16±4.03）min,A组麻醉起效时间较B组显著缩短（t=-23.05,P=0.000）。A组麻醉效果满意度为96.4%,B组为80.6%,A组麻醉满意度高于B组,但差异无统计学意义（χ^2=0.20,P=0.120）。A组术中并发症发生率为7.1%,B组为22.6%,A组并发症发生率较B组显著减少（χ^2=4.53,P=0.040）。结论对于腕横纹以远手外伤,腕部神经阻滞麻醉与肌间沟臂丛麻醉效果均满意,但腕部神经阻滞麻醉具有起效快及并发症少等优势。

Objective To compare the efficacies of wrist nerve block and interscalene brachial plexus block in the treatment of hand injury distal to wrist crease.Methods A total of 59 patients with hand injury distal to wrist crease were randomly assigned to receive either wrist nerve block（group A,n=28）or interscalene brachial plexus block（group B,n=31）.The onset time,satisfaction with anesthesia and intraoperative complications were compared between the two groups.Results Compared with interscalene brachial plexus block,wrist nerve block significantly shortened the onset time of anesthesia[（2.06±1.08）minutes vs（20.16±4.03）minutes,t=-23.05,P=0.000）],and obviously decreased the incidence of intraoperative complications[（7.1% vs 22.6%,χ2=4.53,P=0.040）].In addition,the satisfaction with anesthesia in group A was higher than that in group B（96.4% vs 80.6%,χ2=0.20,P=0.120）.Conclusion Both wrist nerve block and interscalene brachial plexus block provide satisfactory analgesia for hand injury distal to wrist crease.However,wrist nerve block is superior to interscalene brachial plexus block for shortening the onset time of anesthesia and reducing the incidence of complications.