[1]窦雪娇,张子阳,张 红.不同神经阻滞方法对下肢止血带反应的影响[J].医学信息,2019,32(13):104-105108.[doi:10.3969/j.issn.1006-1959.2019.13.030]
　DOU Xue-jiao,ZHANG Zi-yang,ZHANG Hong.Effect of Different Nerve Block Methods on the Reaction of Lower Extremity Tourniquet[J].Journal of Medical Information,2019,32(13):104-105108.[doi:10.3969/j.issn.1006-1959.2019.13.030]
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不同神经阻滞方法对下肢止血带反应的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年13期
页码:
104-105108
栏目:
临床研究
出版日期:
2019-07-01

文章信息/Info

Title:
Effect of Different Nerve Block Methods on the Reaction of Lower Extremity Tourniquet
文章编号:
1006-1959（2019）13-0104-03
作者:
窦雪娇1; 张子阳2; 张 红1
遵义医学院附属医院麻醉科1，烧伤整形外科2，贵州 遵义 563000
Author(s):
DOU Xue-jiao1; ZHANG Zi-yang2; ZHANG Hong1
Department of Anesthesiology1,Department of Burn and Plastic Surgery2,the Affiliated Hospital of Zunyi Medical College, Zunyi 563000,Guizhou,China
关键词:
超声引导神经阻滞; 下肢手术; 止血带
Keywords:
Key words：Ultrasound-guided nerve block; Lower extremity surgery; Tourniquet
分类号:
R614.4
DOI:
10.3969/j.issn.1006-1959.2019.13.030
文献标志码:
A
摘要:
目的 探讨超声引导下不同神经阻滞方法对下肢止血带反应的影响。方法 选取2018年1月~2019年1月在我院择期行足部手术患者40例，随机分为A组和B组，每组20例。A组术前行超声引导下坐骨神经+股神经阻滞，B组术前行超声引导下坐骨神经+股神经+股外侧皮神经+闭孔神经阻滞。比较两组止血带充气即刻（T1）、充气后30 min（T2）、充气后60 min（T3）、充气后90 min（T4）、松止血带时（T5）的VAS评分、心率、MAP，以及手术时间、出血量、术中复合用药情况。结果 A组T2~T4时点心率、MAP及VAS评分高于T1时点，差异有统计学意义（P＜0.05）；A组T5时点心率、MAP及VAS评分与T1~T4时点比较，差异无统计学意义（P＞0.05）。B组T1~T5时点心率、MAP及VAS评分比较，差异无统计学意义（P＞0.05）。两组T1和T5时点VAS评分、心率及MAP比较，差异无统计学意义（P＞0.05）；B组T2~T4时点心率、MAP及VAS评分低于A组，差异有统计学意义（P＜0.05）。结论 超声引导下坐骨神经+股神经+股外侧皮神经+闭孔神经阻滞联合阻滞可以抑制下肢手术的止血带反应，减轻患者疼痛反应。
Abstract:
Abstract：Objective To investigate the effect of different nerve block methods under ultrasound guidance on the reaction of lower extremity tourniquet. Methods 40 patients who underwent elective foot surgery in our hospital from January 2018 to January 2019 were randomly divided into group A and group B, with 20 cases in each group. In group A, ultrasound-guided sciatic nerve+femoral nerve block was performed. In group B, ultrasound-guided sciatic nerve+femoral nerve+lateral femoral cutaneous nerve+obturator nerve block were performed. The VAS scores, heart rate, and MAP of the two groups of tourniquets were immediately inflated (T1), 30 min after inflation (T2), 60 min after inflation (T3), 90 min after inflation (T4), and loose tourniquet (T5). And the operation time, the amount of bleeding, and the intraoperative combined medication. Results The snack rate, MAP and VAS scores in group A T2~T4 were higher than those in T1,the difference was statistically significant (P<0.05).There was no significant difference in heart rate, MAP and VAS score between group A and T1~T4 at T5 time point (P> 0.05). There was no significant difference in T1~T5 time point heart rate, MAP and VAS score in group B(P> 0.05). There were no significant differences in VAS scores, heart rate and MAP between the two groups at T1 and T5 (P>0.05).The snack rate, MAP and VAS scores of group B were lower than those of group A at T2~T4,the difference was statistically significant (P<0.05).Conclusion Ultrasound-guided sciatic nerve + femoral nerve + lateral femoral cutaneous nerve + obturator nerve block combined block can inhibit the tourniquet reaction of lower extremity surgery and reduce the pain response of patients.

参考文献/References:

[1]杨健齐.全膝关节置换术中止血带应用的研究进展[J].中华骨与关节外科杂志,2018,11(11):877-880. [2]刘阳.右美托咪定对臂丛神经阻滞麻醉中止血带反应、血清氧化应激指标的影响[J].贵州医药,2018,42(10):1204-1206. [3]张晓侠,聂明辉,王志学,等.右美托咪定预防超声引导臂丛神经阻滞止血带疼痛效果观察[J].现代仪器与医疗,2017,23(1):35-37. [4]Jiang FZ,Zhong HM,Hong YC,et al.Use of a tourniquet in total knee arthroplasty:a systematic review and meta-analysis of randomized controlled trials[J].J Orthop Sci,2015,20(1):110-123. [5]Lu Y,Zhang Y,Dong CS.Preoperative dexmedetomidine prevents touriniquet-induced hypertention in orthopedic operation during general anesthesis[J].Kaohsiung J Med,2013,29(5):271-274. [6]李静,董补怀,吴续才,等.股神经-坐骨神经联合阻滞在全膝关节置换术中对止血带反应及术后疼痛的影响[J].中国医学科学院学报,2015,37(6):641-644.

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更新日期/Last Update: 2019-07-01