【摘要】 目的探讨臂丛联合颈浅丛神经阻滞在锁骨骨折内固定术中的应用效果。方法选取2017年4月～2018年10月我院收治的64例锁骨骨折患者作为研究对象,按照随机数字表法分为实验组和对照组,每组各32例。对照组采用肌间沟臂丛神经阻滞的方式,实验组采用臂丛联合颈浅丛神经阻滞的方式,对比两组患者的麻醉效果、生命体征[收缩压(SBP)、舒张压(DBP)、心率(HR)及血氧饱和度(SpO2)]、麻醉阻滞范围、辅助麻醉时药物的用量及不良反应发生情况。结果实验组的麻醉优良率显著高于对照组(P<0.05);切皮时对照组患者的SBP和SDP显著高于术前(P<0.05),实验组的SBP和SDP显著低于对照组(P<0.05),其他生命体征比较,差异均无统计学意义(P>0.05);实验组的阻滞范围合格率显著高于对照组(P<0.05);实验组辅助麻醉使用药量显著少于对照组(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论臂丛联合颈浅丛神经阻滞在锁骨骨折内固定术中的临床疗效更好,且安全性良好,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the application effect of brachial plexus combined with superficial cervical plexus nerve block in internal fixation of clavicle fracture. Methods A total of 64 patients with clavicle fracture treated in our hospital from April 2017 to October 2018 were selected as the subjects, and divided into experimental group and control group according to random number table method, with 32 cases in each group. The control group used the method of muscle groove brachial plexus block, and the experimental group used the method of brachial plexus combined with superficial plexus nerve block. The results of anesthesia effect, the patients′ vital signs(SBP, DBP, HR and SpO2), the range of anesthesia block, the dosage of drugs during adjuvant anesthesia and the occurrence of adverse reactions were compared. Results The excellent rate of anesthesia in the experimental group was significantly higher than that in the control group(P<0.05). At the same time, SBP and SDP in the control group were significantly higher than those before operation(P<0.05), and the SBP and SDP in the experimental group were significantly lower than those in the control group(P<0.05). There were no significant differences in other vital signs(P>0.05). The qualified rate of block range in the experimental group was significantly higher than that in the control group(P<0.05). The dosage of adjuvant anesthesia in the experimental group was significantly less than that in the control group(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusion Brachial plexus combined with cervical superficial plexus block has better clinical effect and good safety in the internal fixation of clavicle fracture, which it is worthy of clinical application.更多还原