静脉留置针用于连续臂丛神经阻滞在断指再植中的应用探讨

Study on Application of Vein Detained Needle in the Continuous Brachial Plexus Block in the Replantation of Severed Finger

目的探讨静脉留置针用于连续壁丛神经阻滞在断指再植中的应用效果。方法方便选取2017年3—10月在该院行断指再植术治疗的患者中,选出124例患者纳入随机对照试验中,根据计算机随机分组法将患者分为A组和B组,每组62例。A组患者使用静脉留置针行肌间沟连续壁丛神经阻滞,B组患者使用一针法行单次肌间沟臂丛神经阻滞,通过观察术后4、8、12、24 h患者的疼痛程度及麻醉效果,评估静脉留置针用于连续臂丛神经阻滞在断指再植术中的应用效果。结果 A组麻醉优良率为93.55%,B组麻醉优良率为82.26%,差异有统计学意义(P<0.05);A组术后4、8、12 h及24 h VAS评分均高于B组,差异有统计学意义(P<0.05);A组并发症发生率为0.00%,B组并发症发生率为9.38%,差异有统计学意义(P<0.05)。结论行断指再植术的过程中,使用静脉留置针进行连续臂丛神经阻滞麻醉,可取得理想的麻醉效果,且能减轻患者术后疼痛程度,从而提高断指再植成活率。

Objective To observe the application effect of vein detained needle in the Continuous brachial plexus block in the replantation of severed finger. Methods 124 cases of patients with replantation of severed finger admitted and treated in our hospital from March to October 2017 were convenient selected and randomly divided into two groups with 62 cases in each, the group A used the vein detained needle for interscalene brachial plexus block, while the group B used the one-needle method for single interscalene brachial plexus block, and the pains degree and anesthesia effect of patients in4,8,12,24 h after surgery were observed, and the application effect was evaluated. Results The anesthesia excellent and good rate in the group A and in the group B was respectively 93.55% and 82.26%, and the difference was statistically significant（P〈0.05）, and the VAS scores in 4,8,12, 24 h after surgery in the group A were higher than those in the group B,and the differences were statistically significant（P〈0.05）, and the incidence rate of complications in the group A and in the group B was respectively 0.00% and 9.38%, and the difference was statistically significant（P〈0.05）. Conclusion The anesthesia effect of vein detained needle in the Continuous brachial plexus block in the replantation of severed finger is ideal,which can relieve the postoperative pains degree thus improving the replantation rate of severed finger.