| B超引导下臂丛神经阻滞在儿童尺桡骨骨折手术中的应用 |
| 投稿时间：2017-07-12 修订日期：2017-09-04 点此下载全文 |
| 引用本文：陶蕾,杨世忠.B超引导下臂丛神经阻滞在儿童尺桡骨骨折手术中的应用[J].医学研究杂志,2018,47(4):73-77 |
| DOI：
10.11969/j.issn.1673-548X.2018.04.019 |
| 摘要点击次数: 1166 |
| 全文下载次数: 1125 |
|
| 基金项目:浙江省自然科学基金资助项目（LY14H130035） |
|
| 中文摘要:目的 探究B超引导下臂丛神经阻滞麻醉对尺桡骨骨折患儿术后血清神经生长因子（NGF）、转化生长因子-β（TGF-β）水平变化的影响。方法 选取2014年2月~2017年1月笔者医院78例尺桡骨骨折患儿，将患儿随机分为观察组与对照组，每组各39例。对照组于神经刺激器定位下施行臂丛神经阻滞麻醉，观察组施行B超引导下臂丛神经阻滞麻醉。观察、统计两组麻醉相关指标、麻醉效果及并发症发生情况，并对比两组臂丛神经阻滞0.5h后尺动脉血流动力学参数、手术前后血清NGF、TGF-β水平变化。结果 与对照组相比，观察组麻醉起效、恢复室停留时间均较短，镇痛维持时间较长（P<0.05）；观察组麻醉优良率97.44%（38/39）高于对照组76.92%（30/39），并发症发生率5.12%（2/39）远低于对照组23.08%（9/39，P<0.05）；两组尺动脉收缩期峰速度差异无统计学意义（P>0.05）；与对照组相比，观察组臂丛神经阻滞0.5h后尺动脉舒张末期速度、血流量均较高，阻力及搏动指数均较低（P<0.05）；两组术前血清NGF、TGF-β水平差异均无统计学意义（P>0.05），与对照组相比，观察组术后血清NGF、TGF-β水平均较高（P<0.05）。结论 尺桡骨骨折患儿手术过程中应用B超引导下臂丛神经阻滞麻醉，麻醉效果显著，并发症发生率低，可显著改善尺动脉血流动力学，明显增加血清NGF、TGF-β水平，有助于术后骨折愈合。 |
| 中文关键词:B超 臂丛神经阻滞麻醉 尺桡骨骨折 NGF TGF-β |
| |
| Application of Brachial Plexus Block Guided by B Ultrasound in Operation of Ulna and Radius Fracture in Children |
|
|
| Abstract:Objective To investigate the effect of B-guided brachial plexus block anesthesia on postoperative cognitive function and serum neurotrophic factor (NGF) and transforming growth factor-β (TGF-β) levels in children with ulnar and radius fractures. Methods From February 2014 to January 2017, we selected 78 children with ulnar radius fractures in our hospital randomly and divided them into observation group and control group, each group 39 cases. The control group was given brachial plexus block anesthesia under the position of nerve stimulation, and the observation group was subjected to B-guided brachial plexus block anesthesia. Anesthesia-related indicators, anesthetic effects and complications were observed and analyzed between the two groups, and hemodynamics parameters of brachial plexus block after 0.5h, cognitive function and serum NGF and TGF-β levels before and after operation were compared. Results Compared with the control group, anesthesia onset, recovery room stay time in the observation group were shorter and the duration of analgesia was longer (P<0.05). The excellent and good rate of anesthesia in the observation group 97.44% (38/39) was higher than that in the control group (76.92%, 30/39). The incidence of complications in the observation group 5.12% (2/39) was much lower than that of the control group (23.08%, 9/39, P<0.05). There was no significant difference in systolic peak velocity between the two groups (P>0.05). Compared with the control group, the end of the diastolic velocity and blood flow of brachial plexus block after 0.5h were higher, resistance and pulsatility index were lower (P<0.05). There was no significant difference in preoperative cognitive function, serum NGF and TGF-β levels between the two groups before operation (P>0.05). After operation, compared with the control group, the cognitive function, serum NGF and TGF-β levels were higher in the observation group (P<0.05). Conclusion Anesthesia effect of B-guided brachial plexus block anesthesia is significant in children with ulnar radius fractures. The incidence of complications is low, which can significantly improve the ulnar arterial hemodynamics, significantly increased serum NGF, TGF-β levels, contribute to postoperative fracture healing, and will not affect the cognitive function of children after surgery. |
| keywords:B-ultrasonography Brachial plexus block anesthesia Ulnar radius fracture NGF TGF-β |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
