上海医药
上海醫藥
상해의약
SHANGHAI MEDICAL & PHARMACEUTICAL JOURNAL
2014年
17期
45-47
,共3页
臂丛麻醉%手外伤%急诊
臂叢痳醉%手外傷%急診
비총마취%수외상%급진
brachial plexus anesthesia%hand injury%emergency
目的：比较急诊手外伤术中2种臂丛麻醉方法的效果和安全性。方法：选取2012年10月-2014年5月间我院收治的急诊手外伤并需行手术治疗患者80例，按随机数字法分为A和B两组，每组40例患者。麻醉用药均为0.3%罗哌卡因和1.2%利多卡因的混合液。A组患者接受腋路两点阻滞法麻醉，用量为25 ml；B组患者接受肌间沟两点阻滞法麻醉，用量亦为25 ml。比较两组患者在麻醉前后的血压和心率变化、麻醉效果、不良反应的发生情况和Ramsay镇静评分得分。结果：两组患者麻醉后的血压均出现下降，且A组患者麻醉后的血压高于B组患者，差异有统计学意义（P＜0.05）。两组患者麻醉前后的心率无明显变化，麻醉效果也无明显差异。A组的总不良反应发生率为2.5%，显著低于B组的15%，差异有统计学意义（P＜0.01）。A组中Ramsay镇静评分得分为2~4分的患者比例为80%，高于B组的62.5%，差异有统计学意义（P＜0.05）。结论：急诊手外伤术中臂丛麻醉不会对患者的心率造成明显影响，腋路两点阻滞法麻醉的镇静效果较肌间沟两点阻滞法麻醉更好，可更有效地控制患者的血压、减少不良反应的发生。
目的：比較急診手外傷術中2種臂叢痳醉方法的效果和安全性。方法：選取2012年10月-2014年5月間我院收治的急診手外傷併需行手術治療患者80例，按隨機數字法分為A和B兩組，每組40例患者。痳醉用藥均為0.3%囉哌卡因和1.2%利多卡因的混閤液。A組患者接受腋路兩點阻滯法痳醉，用量為25 ml；B組患者接受肌間溝兩點阻滯法痳醉，用量亦為25 ml。比較兩組患者在痳醉前後的血壓和心率變化、痳醉效果、不良反應的髮生情況和Ramsay鎮靜評分得分。結果：兩組患者痳醉後的血壓均齣現下降，且A組患者痳醉後的血壓高于B組患者，差異有統計學意義（P＜0.05）。兩組患者痳醉前後的心率無明顯變化，痳醉效果也無明顯差異。A組的總不良反應髮生率為2.5%，顯著低于B組的15%，差異有統計學意義（P＜0.01）。A組中Ramsay鎮靜評分得分為2~4分的患者比例為80%，高于B組的62.5%，差異有統計學意義（P＜0.05）。結論：急診手外傷術中臂叢痳醉不會對患者的心率造成明顯影響，腋路兩點阻滯法痳醉的鎮靜效果較肌間溝兩點阻滯法痳醉更好，可更有效地控製患者的血壓、減少不良反應的髮生。
목적：비교급진수외상술중2충비총마취방법적효과화안전성。방법：선취2012년10월-2014년5월간아원수치적급진수외상병수행수술치료환자80례，안수궤수자법분위A화B량조，매조40례환자。마취용약균위0.3%라고잡인화1.2%리다잡인적혼합액。A조환자접수액로량점조체법마취，용량위25 ml；B조환자접수기간구량점조체법마취，용량역위25 ml。비교량조환자재마취전후적혈압화심솔변화、마취효과、불량반응적발생정황화Ramsay진정평분득분。결과：량조환자마취후적혈압균출현하강，차A조환자마취후적혈압고우B조환자，차이유통계학의의（P＜0.05）。량조환자마취전후적심솔무명현변화，마취효과야무명현차이。A조적총불량반응발생솔위2.5%，현저저우B조적15%，차이유통계학의의（P＜0.01）。A조중Ramsay진정평분득분위2~4분적환자비례위80%，고우B조적62.5%，차이유통계학의의（P＜0.05）。결론：급진수외상술중비총마취불회대환자적심솔조성명현영향，액로량점조체법마취적진정효과교기간구량점조체법마취경호，가경유효지공제환자적혈압、감소불량반응적발생。
Objective: To compare the effect and safety of two brachial plexus anesthesia methods in the emergency surgery of hand trauma. Methods: Eighty cases of patients with emergency hand trauma, who were admitted to our hospital during October, 2012-May, 2014 and needed operation, were randomly divided into group A and B with 40 patients each. The anesthetic agent used was a mixture of 0.3%ropivacaine and 1.2%lidocaine. Patients in group A underwent axillary two block anesthesia with dosage of 25 ml while patients in group B received interscalene two block anesthesia with dosage of 25 ml. Blood pressure and heart rate before and after anesthesia, anesthesia effect, incidence of adverse reaction and Ramsay sedation scale score were compared between two groups. Results:Blood pressure in all patients decreased after anesthesia, however, it was higher in group A than in group B and the difference was statistically signiifcant (P<0.05). There were no obvious differences in heart rate and anesthetic effect between two groups before and after anesthesia. The total incidence of adverse reactions occurred at 2.5%in group A and 15%in group B and the difference was statistically signiifcant (P<0.01). The ratio with Ramsay sedation scale score 2~4 points accounted for 80%in group A, which was higher than 62.5%in group B, and the difference was statistically signiifcant (P<0.05). Conclusion:Brachial plexus anesthesia of acute hand injuries can not cause any signiifcant effect on heart rate in patients with axillary block anesthesia. Sedation anesthesia point method is much better than interscalene two block method and can effectively control blood pressure and reduce the adverse reaction.
