超声引导下腕部神经阻滞在断指再植术中的麻醉效果及对手指存活率的影响

Anesthesia Effect of Ultrasound-guided Wrist Nerve Block in Replantation of Severed Finger and Its Influence on the Survival Rate of Fingers

目的:超声引导下腕部神经阻滞在断指再植术中的麻醉效果及对手指存活率的影响。方法:选取笔者所在医院2017年5月-2019年5月收治的100例接受断指再植术的患者,按照随机数字表法将其分为观察组和对照组,每组50例。对照组给予常规性腕部神经阻滞,观察组给予超声引导下腕部神经阻滞。比较两组麻醉效果、手指存活率、疼痛视觉模拟评分量表(VAS)评分、镇痛药物使用情况及镇痛泵按压次数、不良反应发生率。结果:观察组麻醉操作时间及阻滞起效时间明显优于对照组(P<0.05)。观察组麻醉优良率显著高于对照组(P<0.05)。观察组手指存活率显著高于对照组(P<0.05)。观察组VAS评分显著低于对照组(P<0.05)。观察组镇痛药物使用率及镇痛泵按压次数显著少于对照组(P<0.05)。两组神经损伤、麻药中毒、血肿及感染率比较,差异均无统计学意义(P>0.05)。结论:超声引导下腕部神经阻滞在断指再植术的效果显著,可有效提高断指存活率,减轻患者疼痛程度,同时比常规性腕部神经阻滞起效时间更短,麻醉优良率更高,值得临床推广和使用。

Objective:To investigate the anesthesia effect of ultrasound-guided wrist nerve block in replantation of severed finger and its influence on the survival rate of fingers.Method:A total of 100 patients who received replantation of severed finger in our hospital from May 2017 to May 2019 were selected and divided into the observation group and the control group according to the method of random number table,with 50 patients in each group.The control group was given regular wrist nerve block,and the observation group was given ultrasound-guided wrist nerve block.The anesthesia effect,finger survival rate,visual analogue scale(VAS)score,analgesic drugs use and times of analgesic pump pressure and adverse reaction rate were compared between the two groups.Result:The anesthesia operation time and block onset time in the observation group were significantly better than those in the control group(P<0.05).The rate of excellent and good anesthesia in the observation group was significantly higher than that in the control group(P<0.05).The survival rate of fingers in the observation group was significantly higher than that in the control group(P<0.05).The VAS score in the observation group was lower than that in the control group(P<0.05).The rate of analgesic drug use and the times of analgesic pump pressure in the observation group were significantly less than those in the control group(P<0.05).There were no significant differences in nerve injury,anesthetics poisoning,hematoma and infection rate between the two groups(P>0.05).Conclusion:Ultrasound-guided wrist nerve block has a significant effect in replantation of severed finger.It can effectively improve the survival rate of severed finger and relieve the pain degree of patients.Meanwhile,compared with regular wrist nerve block,the onset time is shorter,the rate of excellent and good anesthesia is higher,which is worthy of clinical promotion and use.