高频超声引导下臂丛神经显像和定位的应用价值分析

Application value of high frequency ultrasound in imaging and localization of brachial plexus

目的探讨高频超声引导下在臂丛神经显像和定位阻滞麻醉中应用效果。方法选取2015年1月-2016年4月我院行择期上肢手术患者93例为研究对象,根据患者麻醉阻滞方式不同分为研究组（超声引导下臂丛神经阻滞,48例）和对照组（盲穿臂丛神经麻醉阻滞,45例）,比较两组患者穿刺成功率、感觉阻滞起效时间、感觉阻滞完全时间、运动阻滞起效时间、麻醉用药量及并发症发生情况。结果研究组患者一次性穿刺成功率为100.00%,显著高于对照组82.22%一次性穿刺成功率,比较有统计学意义（P〈0.05）。研究组患者感觉阻滞起效时间、感觉阻滞完全时间、运动阻滞起效时间、麻醉用药量均低于对照组,比较有统计学意义（P〈0.05）。研究组患者运动阻滞0、Ⅰ、Ⅱ级例数少于对照组,Ⅲ级例数多于对照组,比较有统计学意义（P〈0.05）。研究组患者血管损伤、穿刺部位水肿并发症发生率均低于对照组,比较有统计学意义（P〈0.05）。结论高频超声引导下臂丛神经穿刺阻滞麻醉,在动态观察下进行操作,可有效提高患者穿刺成功率,提高麻醉效果,降低并发症发生率,具有较高临床应用价值。

Objective To explore the application effect of high frequency ultrasound in imaging and block anesthesia of brachial plexus. Methods 93 elective upper limb surgery patients, who were in our hospital from April January 2015 to 2016,were chosen as the research object. According to the different anesthesia block, the patients were divided into study group（ultrasound-guided brachial plexus block,48 cases）and control group（Blind brachial plexus block,45 cases）.The success rate,sensory block onset time, sensory block full time, motor block onset time, the amount of narcotic medication and occurrence of complications were compared between two groups. Results The success rate of one time puncture in the study group was 100%,and that of the control group was 82.22%.The study group was significantly higher than the control group on the success rate of one time puncture, and the difference was statistically significant（P〈0.05）.The onset time of sensory block, the complete time of sensory block, the onset time of motor block,the dosage of anesthesia in the study group were lower than those in the control group（P〈0.05）.The number of patients with motor block grade 0,motor block grade I and motor block grade II in the study group was less than that in the control group, the number of motor block III of the study group was more than that of the control group, and there were statistical significance（P〈0.05）.The incidence of vascular injury and edema in the study group was lower than that in the control group,and there was statistical significance（P〈0.05）. Conclusion To operate in dynamic observation,high frequency ultrasound guided brachial plexus puncture block anesthesia can effectively improve puncture success rate, improve the anesthetic effect,reduce the incidence of complications, and has high clinical application value.