超声引导臂丛神经阻滞在锁骨及上肢骨折手术中的应用

Application of Ultrasound-guided Brachial Plexus Block in the Operation of Clavicle and Upper Extremity Fractures

目的探讨锁骨及上肢骨折手术治疗患者采取超声引导臂丛神经阻滞麻醉的临床效果及价值。方法选择江苏省连云港市赣榆区人民医院2018年1月—2021年10月接受锁骨及上肢骨折手术治疗的60例患者为研究对象,根据抛硬币结果分作观察组(硬币正面,30例)与对照组(硬币背面,30例)。对照组采取传统方法麻醉,观察组实施超声引导下臂丛神经阻滞麻醉,对比两组患者麻醉质量,记录比较各组患者臂丛神经主要分支(尺神经、正中神经、肌皮神经、桡神经)阻滞麻醉的起效时间及完全阻滞率,统计对比两组患者并发症总发生率。结果观察组患者麻醉优良率100.00%明显高于对照组,差异有统计学意义(χ^(2)=5.822,P<0.05),观察组患者臂丛神经主要分支阻滞麻醉起效时间均短于对照组,完全阻滞率高于对照组,差异有统计学意义(P<0.05)。观察组患者并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论患者接受锁骨及上肢骨折手术治疗时采取超声引导臂丛神经阻滞麻醉具有确切效果,能够有效提高麻醉精准性,安全性高。

Objective To investigate the clinical effect and value of ultrasound-guided brachial plexus block anesthesia in patients with clavicle and upper extremity fractures.Methods A total of 60 patients who received surgical treatment of clavicle and upper extremity fractures from January 2018 to October 2021 in Ganyu District People’s Hospital of Lianyungang City,Jiangsu Province were selected as the research subjects.The control group(the back of the coin,30 cases),the control group was anesthetized by traditional methods,and the observation group was anesthetized by ultrasound-guided brachial plexus block.,median nerve,musculocutaneous nerve,radial nerve block anesthesia onset time and complete block rate,statistical comparison of the total incidence of complications in the two groups of patients.Results The excellent and good rate of anesthesia in the observation group was significantly higher than that in the control group(100.00%),and the difference was statistically significant(χ^(2)=5.822,P<0.05).The block rate was higher than that of the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided brachial plexus block anesthesia has definite effect in patients undergoing clavicle and upper limb fracture surgery,which can effectively improve the accuracy of anesthesia and has high safety.