肌间沟联合腋路在手部断指手术中的对比分析

Contrastive Analysis of the Technique of Muscle Interbody Combined With Axillary Surgery in Hand

目的研究肌间沟联合腋路在手部断指手术中的麻醉效果。方法选择2015年2月—2017年5月手部断指手术患者90例作为研究对象。将其随机分为两组,每组各45例。肌间沟组实施肌间沟臂丛神经阻滞麻醉;肌间沟+腋路组实施肌间沟联合腋路臂丛神经阻滞麻醉。比较两组患者手术过程疼痛评分、麻醉优良率以及麻醉过程不良反应发生率。结果肌间沟+腋路组患者手术过程疼痛评分为(1.14±0.15)分,低于肌间沟组的(2.43±1.11)分,组间对比,差异具有统计学意义(P<0.05)。肌间沟+腋路组患者的麻醉优良率高于肌间沟组,组间对比,差异具有统计学意义(P<0.05)。肌间沟组中,麻醉效果优19例,良16例,差10例,优良率为77.78%;肌间沟+腋路组中,麻醉效果优38例,良6例,差1例,优良率97.78%。两组患者麻醉过程均不良反应无出现,组间对比,差异无统计学意义(P>0.05)。结论肌间沟联合腋路在手部断指手术中的应用效果确切,可有效减轻患者疼痛,确保手术顺利进行,且无不良反应,安全性高,优于单一肌间沟臂丛神经阻滞麻醉,可作为手部断指手术的理想麻醉方式。

Objective To study the comparison of myometrium combined with axillary approach in the operation of hand injury. Methods 90 cases with hand replantation were selected from February 2015 to May 2017. The patients were randomly divided into two groups, 45 cases in each group. Intermuscular sulcus brachial plexus block anesthesia was performed in intermuscular groove group. Intermuscular groove ＋ axillary brachial plexus block anesthesia was performed in intermuseular groove ＋ axillary approach group. The operation process, pain score, excellent rate of anesthesia and the incidence of adverse reactions during the anesthesia were compared between the two groups. Results The pain score of intermuscular groove ＋ axillary approach group was （1.14~0.15） points, less than （2.43~1.11） points in the intermuscular sulcus, the difference between the two groups was statistically significant （P〈0.05）. The excellent rate of anesthesia between the intermuscular groove ＋ axillary group was higher than that of the intermuscular groove group, and the difference between the two groups was statistically significant （P〈0.05）. Among them, the effect of anesthesia was excellent in 19 cases, good in 16 cases, poor in 10 cases, the excellent and good rate was 77.78%. The effect of anesthesia in the intermuscular groove ＋ axillary group was excellent in 38 cases, good in 6 cases, poor in 1 case, and the excellent and good rate was 97.78%. The two groups of patients had no adverse reactions during the anesthesia, and there was no significant difference between the two groups （P〉0.05）. Conclusion The application of musculocutaneous joint axillary approach in the operation of hand injury is effective, which can effectively reduce the pain of the patient~ and ensure the smooth operation of the patients.There is no adverse reaction and high safety, which is superior to the single interosseous brachial plexus ganglion anesthesia can be used as an ideal method of anesthesia for hand injury.