本文選題：骶管麻醉　切入點(diǎn)：B超引導(dǎo)法　出處：《中國(guó)現(xiàn)代醫(yī)學(xué)雜志》2017年20期 　論文類型：期刊論文

【摘要】：目的探索B超定位引導(dǎo)骶裂孔穿刺法和傳統(tǒng)體表定位法穿刺骶管麻醉的成功率與并發(fā)癥。方法選取該院肛腸科和泌尿外科97例會(huì)陰部手術(shù)患者,隨機(jī)分為兩組,觀察組(B超定位)51例,對(duì)照組(傳統(tǒng)方法)46例。觀察組采取線性高頻B超探頭縱橫十字交叉法定位。探及骶裂孔后,將縱置的探頭下部置于骶裂孔上方,采用聲場(chǎng)內(nèi)平面技術(shù),將注射針頭經(jīng)超聲探頭下緣,與皮膚呈45°角緩慢進(jìn)針。根據(jù)超聲實(shí)時(shí)顯像圖像,引導(dǎo)和調(diào)整穿刺方向及深度,直至針尖完全位于骶管腔中。對(duì)照組采取傳統(tǒng)體表定位法穿刺。結(jié)果觀察組一次穿刺成功率、血管損傷率、穿刺次數(shù)及穿刺時(shí)間與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組1例穿刺失敗,是因?yàn)槌醮螌?shí)施B超定位穿刺時(shí),未注意避開靜脈叢,導(dǎo)致血管損傷。結(jié)論 B超引導(dǎo)下骶管麻醉,不但大大提高穿刺成功率,而且節(jié)約操作時(shí)間,減少穿刺次數(shù),減少血管損傷并發(fā)癥,有很好的臨床推廣應(yīng)用價(jià)值。
[Abstract]:Objective to explore the success rate and complications of sacral canal anesthesia guided by B-ultrasound guided sacral fissure puncture and traditional body surface positioning. Methods 97 patients with pudendal surgery were randomly divided into two groups. The observation group (51 cases of B-ultrasonic localization and 46 cases of control group) were treated with linear high-frequency B-mode ultrasound probe longitudinal and transverse cross crossing method. After probing the sacral hole, the lower part of the longitudinal probe was placed above the sacral fissure, and the acoustic field plane technique was used. The needle was injected through the lower edge of the ultrasonic probe and slowly entered the needle at an angle of 45 擄with the skin. According to the real-time ultrasound image, the direction and depth of the puncture were guided and adjusted. Results the success rate of single puncture, the rate of vascular injury, the times of puncture and the time of puncture in the observation group were compared with those in the control group. The difference was statistically significant (P 0.05). The failure of puncture in one case in the observation group was due to the failure to avoid venous plexus in the first time. Conclusion the sacral canal anesthesia guided by B-ultrasound can not only improve the success rate of puncture, but also improve the success rate of puncture. It also saves the operation time, reduces the puncture times and reduces the complications of vascular injury, so it has a good clinical application value.
【作者單位】： 南京中醫(yī)藥大學(xué)附屬連云港市中醫(yī)院麻醉科;
【分類號(hào)】：R614

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