CAJ | 학술논문

目的评价国产钢丝加强型硬膜外导管对硬膜外阻滞实施中不良事件发生的影响.方法选择拟行脊椎-硬膜外联合阻滞的择期手术患者300例,年龄18～64岁,体重41～ 78 kg,ASA分级Ⅰ或Ⅱ级.采用随机数字表法,将其随机分为3组(n=100):普通聚氯乙烯硬膜外导管组(A组)、进口钢丝加强型硬膜外导管组(B组)和国产钢丝加强型硬膜外导管组(C组).常规行脊椎-硬膜外联合阻滞,各组置入相应的硬膜外导管.记录硬膜外置管通畅情况、置管时感觉异常、回抽见血或脑脊液、穿刺误入血管、注药遇阻、拔除硬膜外导管难易情况、拔管后出血、术后感觉异常及术后1周内硬膜外血肿的发生情况.结果与A组比较,B组和C组硬膜外置管时感觉异常、回抽见血或脑脊液、注药遇阻和术后感觉异常的发生率降低(P＜0.05),其余指标差异无统计学意义(P＞0.05)；B组和C组各指标比较差异无统计学意义(P＞0.05).结论国产钢丝加强型硬膜外导管可降低置管损伤神经及血管的发生机率,其效果与进口钢丝加强型硬膜外导管相似.
목적 평개국산강사가강형경막외도관대경막외조체실시중불량사건발생적영향.방법 선택의행척추-경막외연합조체적택기수술환자300례,년령18～64세,체중41～ 78 kg,ASA분급Ⅰ혹Ⅱ급.채용수궤수자표법,장기수궤분위3조(n=100):보통취록을희경막외도관조(A조)、진구강사가강형경막외도관조(B조)화국산강사가강형경막외도관조(C조).상규행척추-경막외연합조체,각조치입상응적경막외도관.기록경막외치관통창정황、치관시감각이상、회추견혈혹뇌척액、천자오입혈관、주약우조、발제경막외도관난역정황、발관후출혈、술후감각이상급술후1주내경막외혈종적발생정황.결과 여A조비교,B조화C조경막외치관시감각이상、회추견혈혹뇌척액、주약우조화술후감각이상적발생솔강저(P＜0.05),기여지표차이무통계학의의(P＞0.05)；B조화C조각지표비교차이무통계학의의(P＞0.05).결론 국산강사가강형경막외도관가강저치관손상신경급혈관적발생궤솔,기효과여진구강사가강형경막외도관상사.
Objective To evaluate the effect of domestic wire-reinforced epidural catheter on the occurrence of adverse events during epidural block.Methods Three hundred ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,weighing 41-78 kg,scheduled for elective operations under combined spinal-epidural anesthesia,were randomly divided into 3 groups (n =100 each):polyvinyl chloride epidural catheter group (group A),imported wire-reinforced epidural catheter group (group B) and domestic wire-reinforced epidural catheter group (group C).Combined spinal-epidural anesthesia was performed routinely.The corresponding epidural catheter was inserted in each group.The catheterization without difficulty,paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,intravascular catheter insertion,injection obstruction,easiness during removal of the catheter,bleeding after removal,postoperative paresthesia and epidural hematoma within 1 week after operation were recorded.Results Compared with A group,the incidences of paresthesia during catheterization,the number of patients in whom blood or cerebrospinal fluid was withdrawn from the epidural catheter,injection obstruction and postoperative paresthesia were significantly decreased (P ＜ 0.05),and no significant change was found in the other parameters in B and C groups (P ＞ 0.05).There was no significant difference in all the parameters between B group and C group (P ＞ 0.05).Conclusion Domestic wire-reinforced epidural catheter can decrease the occurrence of catheterization-induced damage to the nerve and blood vessels and the efficacy is comparable with that of imported wire-reinforced epidural catheter.