超声引导下臂丛神经阻滞对肩关节镜手术患者术后快速康复的影响.docxVIP

超声引导下臂丛神经阻滞对肩关节镜手术患者术后快速康复的影响 　　[摘要]目的探討超声引导下臂丛神经阻滞对肩关节镜手术患者术后快速康复的影响。方法选取2017年6月～2019年9月在我院骨科改关节外科行肩关节镜手术的60例患者，随机分为两组，对照组单用全身麻醉，在此基础上观察组行超声引导下臂丛神经阻滞，对比两组的术中血流动力学变化、术后疼痛情况、术后不同时间上肢功能。结果观察组在手术开始5min（t1）、手术开始30min（t2）、手术结束时（t3）、拔除气管导管30min时（t4）的hr和map均低于对照组（p0.05）;观察组苏醒即刻、术后6h、术后12h、术后24h的vas疼痛评分均低于对照组（p0.05）;观察组术后6h、12h、24h的上肢功能评分明显高于对照组（p0.05）。结论超声引导下臂丛神经阻滞在肩关节镜手术的麻醉效果良好，能有效稳定术中血流动力学，减轻术后疼痛，加快上肢功能的恢复锻炼，具有积极的临床意义。 　　[关键词]肩关节镜手术;超声引导下臂丛神经阻滞;术后快速康复;上肢功能 　　[中图分类号]r614[文献标识码]b[文章编号]1673-9701（2020）08-0133-04 　　impactsofultrasound-guidedbrachialplexusblockonfasttrackrehabilitationaftershoulderarthroscopy 　　huangzhiqiangzhangweiqiangluorongzengzhiwen 　　the1stdepartmentofanesthesiology，meizhoupeopleshospitalinguangdongprovince，meizhou514000，china 　　[abstract]objectivetoinvestigateimpactsofultrasound-guidedbrachialplexusblockonfasttrackrehabilitationaftershoulderarthroscopy.methodssixtypatientstransferredfromthedepartmentoforthopedicsatourhospitaltothedepartmentofjointsurgeryforshoulderarthroscopyfromjune2017toseptember2019wererandomlydividedintotwogroups.patientsinthecontrolgroupunderwentgeneralanesthesia，whilethoseintheobservationgroupadditionallyreceivedultrasound-guidedbrachialplexusblock.haemodynamics，postoperativepainandupperlimbfunctionatdifferenttimepointsaftershoulderarthroscopywerecomparedbetweenthetwogroups.resultsheartrate（hr）andmeanarterialbloodpressure（map）intheobservationgroupweresignificantlylowerthanthecontrolgroupat5min（t1）and30minafterthebeginningofsurgery（t2），attheendofsurgery（t3）andat30minafterextubation（t4）（p0.05）.visualanaloguescale（vas）scoresatanesthesiarecoverytimeand6h，12hand24haftersurgeryintheobservationgroupweresignificantlylowerthanthecontrolgroup（p0.05）.scoresofupper-limbfunctionassessmentat6h，12hand24haftersurgeryintheobservationgroupweresignificantlyhigherthanthecontrolgroup（p0.05）.conclusionultrasound-guidedbrachialplexusblockduringgeneralanesthesiainshoulderarthroscopyshowedfavorableanestheticeffects.itstablymain