颈臂丛神经阻滞在肱骨外科颈粉碎性骨折术中的应用.pdfVIP

18 美中国际创伤杂志 2007年12月第6卷 第4期 颈臂丛神经阻滞在肱骨外科颈粉碎性骨折术中的应用 孙晓娟，肖莉，张洁，罗镇国 (西安市红十字会医院麻醉科 710054) [摘要]目的：针对与肱骨外科颈粉碎性骨折探索一种更切实可行，镇痛效果更加完善的神经阻滞方法。方法：选择 ASA I～Ⅱ级肱骨外科颈粉碎性骨折接受手术治疗的病人150例，随机分为2组：A组(n=75)麻醉采用常规单纯臂丛 神经阻滞；B组(n=75)麻醉采用颈臂丛联合神经阻滞，观察患者的麻醉效果，镇痛强度，及出现并发症的机率。结果： B组麻醉发生阻滞不全者明显较A组少，两组均未见局麻药毒性反应和并发症。结论：肱骨外科颈粉碎性骨折手术 采用颈臂丛联合神经阻滞麻醉效果优于单纯臂丛神经阻滞，镇痛更加完全，麻醉效果满意。 [关键词]肱骨外科颈粉碎性骨折；颈臂丛神经阻滞；臂丛神经阻滞 中图分类号：R683．41 文章编号：1538-814X(2007)04-0018-02 Application of Plexus Cervicobrachialis Nerve Block for Comminuted Fracture of Collum Chirur~culn Humeri／／Sun Xiaojuan，Xioo Li，Zhang皿，et a1．Department of Anesthesiology，Red Cross Hospital of Xi’帆， Xi’帆 710054,China 【Abstract】Objective：To explore a more feasible method of nerve block for patients with comminuted fracture of collum chirurgicum humeri．Mehtods：150 ASA I～I1 cases of comminuted fracture of collum chirurgicum humeri were divided into two groups at random．25 cases in each group，simple brachial plexus block was performed on group A patients and cervicobrachial plexus block was performed on group B patients．The anesthesia effects，side effects，and satisfaction degree were observed．Results：Incidence of incomplete nerve block in group B was lower than that of group A obviously．There was no toxic reaction or complications appeared．Conclusion： The anestllesia effect of cervicobrachial plexus block for patients with comminuted fracture of collum chirurgicum humeri is superior to that of simple brachial plexus block，and the analgesia intensity and effect is better． [Key words]Comminuted fracture of collum chirurgicum humeri；Cervicobrachial plexus block；Brachial plexus block 2006年5月至2007年 1月我院共收治肱骨外 时监测ECG、BP、SpO，和RR。 科颈骨折患者223例，约85％为粉碎性骨折，复位 1．2 阻滞方法 嘱患者仰卧去枕，头偏向对侧，确定 困难，固定复杂。常规阻滞方法患者易出现麻醉