超声引导下神经阻滞对桡骨远端骨折手术患者麻醉效果及肺功能的影响

Effect of Ultrasound-guided Supraclavicular Brachial Plexus Block on Anesthesia and Pulmonary Function in Patients with Distal Radius Fracture

目的探讨桡骨远端骨折手术采用超声引导锁骨上臂丛神经阻滞(SCBPB)的临床意义。方法选取2018年12月至2020年12月博罗县人民医院收治的桡骨远端骨折手术患者50例作为研究对象,采用随机数字表法分为超声组和传统组,各25例。超声组行超声引导下SCBPB,传统组行传统神经阻滞。比较两组麻醉效果及阻滞前后的肺功能,记录两组并发症发生情况。结果超声组患者麻醉优秀率为72.0%,传统组麻醉优秀率为40.0%,两组麻醉优秀率相比差异有统计学意义(P<0.05)。与治疗前相比,治疗后两组患者用力肺活量(FVC)、用力肺活量占预计值的百分比(FVC%)、第一秒钟用力呼气容积(FEV_(1))均不同程度降低,且超声组低于传统组,差异有统计学意义(P<0.05)。超声组手术过程中并发症发生率低于传统组,差异有统计学意义(P<0.05)。结论超声引导下SCBPB效果显著,还可维护桡骨远端骨折手术患者肺功能,且安全性高。

Objective To explore the clinical significance of supraclavicular brachial plexus block(SCBPB)guided by ultrasound in distal radius fracture surgery.Methods 50 patients with distal radius fracture who were admitted to Boluo County People's Hospital from December 2018 to December 2020 were selected as the research objects.They were randomly divided into ultrasonic group and traditional group with 25 patients each.Ultrasound guided SCBPB was performed in the ultrasound group,and traditional nerve block was performed in the traditional group.The effect of anesthesia and pulmonary function before and after block,and the occurrence of complications in the two groups were compared.Results The excellent rate of anesthesia in ultrasonic group was 72.0%,and that in traditional group was 40.0%.There was a significant difference between the two groups(P<0.05).Compared with those before treatment,forced vital capacity(FVC),percentage of forced vital capacity to estimated value(FVC%),and forced expiratory volume in the first second(FEV_(1))of patients in the two groups decreased to varying degrees after treatment,and the ultrasonic group was lower than the traditional group,with a statistically significant difference(P<0.05).The incidence of complications in the ultrasonic group was lower than that in the traditional group(P<0.05).Conclusion Ultrasound-guided SCBPB anesthesia has significant effect,can also maintain the pulmonary function of patients with distal radius fracture,and has high safety.