连续臂丛神经阻滞镇痛对断指再植术后再植指血流动力学的影响分析

Effect of continuous brachial plexus blockade on hemodynamics of replantation finger replantation

目的：研究连续臂丛神经阻滞镇痛用于断指再植术后再植指血流动力学的影响.方法：在我院2015年2月-2017年2月间收治的断指患者中选出60例为研究对象,全部患者均接受断指再植术治疗,随机将患者分成对照组和观察组,其中对照组患者给予常规镇痛方法,观察组患者给予连续臂丛神经阻滞镇痛法,对比2组患者再植指血流动力学指标、VAS评分、不良反应发生率.结果：观察组患者术后24小时的再植指收缩期峰值血流速度、舒张期血流速度、平均血流速度均比对照组高,且阻力指数更低,P〈0.05;观察组患者术后3天、6小时、12小时、24小时的VAS评分更低,且不良反应发生率6.67%,低于对照组的30.0%,P〈0.05.结论：对断指再植患者术后镇痛中采用连续臂丛神经阻滞镇痛效果确切,减轻患者再植指的疼痛程度,且安全性高,有助于促进患者再植指血流动力学的改善,利于提高断指成活率,值得推广应用.

Objective ： To study the effect of continuous brachial plexus block analgesia on hemodynamics after replantation of severed fingers. Methods： In our hospital from February 2015 to February 2017 were amputated patients selected 60 cases as the research object, all the patients underwent replantation of treatment, patients were randomly divided into control group and observation group, the control group were given routine analgesia, observation group were given continuous braehial plexus block analgesia, compared to two patients with replantation hemodynamics, VAS score, the incidence of adverse reaction. Results： Patients with 24h after replantation of peak sys- tolic velocity, diastolic velocity and mean velocity were higher than the control group, and the resistance index lower, P 〈 0.05 ; the patients in the observation group after 3D, 6h, 12h, 24h, VAS were lower, and the incidence of adverse reactions was 6.67% lower than that of the control group 30%, P 〈 0.05. Conclusion： The patients after finger replantation and analgesic effect of continuous brachial plexus block analgesia, reduce the degree of pain in patients with replantation, and high safety, help to promote the patients with replantation of hemodynamic improvement, could improve the survival rate of replantation of amputated finger, so it might be worthy to be used.