摘要
目的:研究对进行上肢手术的患儿实施超声引导下臂丛神经阻滞麻醉联合全身麻醉的效果。方法:对近年来在四川省凉山州会东县中医医院进行上肢手术的74例患儿的临床资料进行回顾性研究。将这74例患儿随机分为对照组(n=37)和观察组(n=37)。对观察组患儿进行超声引导下臂丛神经阻滞麻醉联合全身麻醉,对对照组患儿进行神经刺激器定位下臂丛神经阻滞麻醉联合全身麻醉,然后比较两组患儿麻醉的效果、手术持续的时间、术中七氟醚的用量及术中尺动脉的舒张末期流速、血流阻力指数及血流量。结果:观察组患儿麻醉效果的优良率高于对照组患儿,差异有统计学意义(P<0.05)。观察组患儿手术持续的时间短于对照组患儿,其术中七氟醚的用量少于对照组患儿,差异有统计学意义(P<0.05)。术中,观察组患儿尺动脉的舒张末期流速和尺动脉的血流量均大于对照组患儿,其尺动脉的血流阻力指数小于对照组患儿,差异有统计学意义(P<0.05)。结论:对进行上肢手术的患儿实施超声引导下臂丛神经阻滞麻醉联合全身麻醉的效果显著,能有效地缩短其手术持续的时间,提高其麻醉的效果,减少其术中七氟醚的用量,且术中对其血流动力学的各项指标影响较小。
Objective：To analyze the effect of brachial plexus nerve block of lower arm under guidance of ultrasound combined with general anesthesia for the children accepting upper extremity surgery.Methods：Retrospectively research the clinical material of 74 cases of children accepting upper extremity surgery in The Traditional Chinese Medical Hospital of Huidong County in recently years.Randomly divide the cases to control group（n=37）and experimental group（n=37）.In surgery process,we treat experimental group with brachial plexus nerve block of lower arm combined with general anesthesia under guidance of ultrasound,treat control group with brachial plexus nerve block of lower arm combined with general anesthesia under nerve stimulator location,then compare anesthetic effect,operative time,dosage of sevoflurane,end-diastolic velocity of the ulnar artery,resistant index,blood flow volume of 2 groups.Results：The excellent and good rate of anesthetic effect of experimental group is higher than that in control group（P〈0.05）.The operative time of experimental group is shorter than that in control group,dosage of sevoflurane for experimental group is less than that in control group（P〈0.05）.The end-diastolic velocity of the ulnar artery and blood flow volume of experimental group are larger than that in control group,resistant index of experimental group is less than that in control group（P〈0.05）.Conclusion：The effect of brachial plexus nerve block of lower arm under guidance of ultrasound combined with general anesthesia for the children accepting upper extremity surgery is significant,it will shorten operative time,improve anesthetic effect,decrease dosage of sevoflurane,and it have less effect to hemodynamic index.
作者
罗玉
LUO yu(The Traditional Chinese Medical Hospital of Huidong County Liangshan Sichuan 61520)
关键词
上肢手术
超声引导下臂丛神经阻滞麻醉
全身麻醉
upper extremity surgery
brachial plexus nerve block of lower arm under guidance of ultrasound
general anesthesia
