CAJ | 학술논문

目的研究连续臂丛神经阻滞镇痛对断指再植术后再植指血流动力学的影响，探讨其缓解血管痉挛、增加血流量的可行性。方法将60例急诊行断指再植术患者按随机数字表法分为术后连续臂丛神经阻滞镇痛组（CA组）和对照组（NA组），每组30例。观察两组患者再植指术后血管痉挛、血管栓塞和指体坏死发生例数并计算再植指成活率，记录两组术后即刻（T1）、术后24h（T2）再植指固有动脉血流动力学参数及动脉内径（AD）、远指端血氧饱和度（SpO2）和温度（Ts）变化。结果断指再植术后成活率CA组高于NA组，血管痉挛、血管栓塞和指体坏死发生率CA组均低于NA组，差异均有统计学意义（均P＜0.05）。在T2时CA组各项血流动力学参数、AD、SpO2、Ts均高于NA组，阻力指数（RI）低于NA组，差异均有统计学意义（均P＜0.05）。结论术后连续臂丛神经阻滞镇痛可以缓解再植指固有动脉痉挛，增加指体血流量，提高了断指再植的成功率。
목적연구련속비총신경조체진통대단지재식술후재식지혈류동역학적영향，탐토기완해혈관경련、증가혈류량적가행성。방법장60례급진행단지재식술환자안수궤수자표법분위술후련속비총신경조체진통조（CA조）화대조조（NA조），매조30례。관찰량조환자재식지술후혈관경련、혈관전새화지체배사발생례수병계산재식지성활솔，기록량조술후즉각（T1）、술후24h（T2）재식지고유동맥혈류동역학삼수급동맥내경（AD）、원지단혈양포화도（SpO2）화온도（Ts）변화。결과단지재식술후성활솔CA조고우NA조，혈관경련、혈관전새화지체배사발생솔CA조균저우NA조，차이균유통계학의의（균P＜0.05）。재T2시CA조각항혈류동역학삼수、AD、SpO2、Ts균고우NA조，조력지수（RI）저우NA조，차이균유통계학의의（균P＜0.05）。결론술후련속비총신경조체진통가이완해재식지고유동맥경련，증가지체혈류량，제고료단지재식적성공솔。
Objective To investigate the influence of continuous axil ary brachial plexus nerve block analgesia on hemo-dynamics fol owing finger replantation. Methods Sixty patients undergoing finger replantation were randomly divided into brachial plexus nerve block analgesia group (CA group, n=30) and control group (NA group, n=30). The incidence of vascular spasm, vascular embolization and finger body necrosis and survival rate of replanted fingers, the parameters of hemodynamics, arterial diameter (AD), SpO2 and Ts changes were observed immediately (T1) and 24 h (T2) after operation. Results The survival rate of replanted finger in CA group was higher than that NA group (P<0.05). The incidence of vascular spasm, vascular em-bolization and finger body necrosis in CA group was lower than that in NA group(P<0.05). The hemodynamic parameters Vs, Vd, Vm and AD, SpO2, Ts in CA group were higher and RI in CA group was lower than those in NA group (P<0.05). Conclusion Postoperative continuous brachial plexus nerve block analgesia can al eviate the proper artery spasm, increase the finger blood stream and improve the success rate of finger replantation.