本文選題：股神經阻滯 + 坐骨神經阻滯　； 參考：《鄭州大學學報(醫(yī)學版)》2017年03期

【摘要】：目的:探討皮膚溫度(皮溫)變化對感覺缺失區(qū)域神經阻滯效果的評估價值。方法:選擇擇期行下肢肌痙攣松解手術的截癱患者58例,在手術側行超聲引導下單側股神經+坐骨神經阻滯,股神經周圍注射2.5 mg/L羅哌卡因15 mL,坐骨神經周圍注射5.0 mg/L羅哌卡因10 mL。隨機在兩側下肢股神經支配的股內側肌區(qū)域、隱神經支配的小腿內側區(qū)域、坐骨神經支配的股二頭肌區(qū)域、小腿腓腸肌區(qū)域皮膚上各取一個測量點,記錄注藥前、注藥后5 min的皮溫。阻滯側和非阻滯側皮溫變化值(T_阻和T_非)為注藥前后皮溫的差值,校準的阻滯側皮溫變化值(T_校)=T_阻-T_非。結果:兩側各有232個測量點,T_阻=-(1.8±0.5)℃,T_非=-(0.5±0.3)℃,T_校=-(1.2±0.6)℃。其中阻滯側202個點神經阻滯效果佳,30個點神經阻滯效果差。T_校與神經阻滯效果呈較強的負相關關系(r_S=-0.758,95%CI=-0.790~-0.572)。以T_校對神經阻滯效果繪制ROC,則曲線下面積為0.912(95%CI=0.806~0.973),診斷臨界值為-1.2℃,此時的診斷敏感度達83.3%,特異度達81.7%。結論:皮溫變化是評估皮膚感覺缺失情況下神經阻滯效果的有價值指標。
[Abstract]:Objective: to evaluate the effect of skin temperature on nerve block in sensory missing area. Methods: Fifty-eight paraplegic patients undergoing spasticity of lower extremity were selected and treated with unilateral sciatic nerve block guided by ultrasound. Ropivacaine (2.5 mg/L) was injected around the femoral nerve (15 mL) and ropivacaine (5.0 mg/L) was injected around the sciatic nerve (10 mL). The medial femoral muscles innervated by the lower extremities, the medial region of the leg innervated by the saphenous nerve, the biceps femoris muscle innervated by the sciatic nerve and the gastrocnemius muscle region of the leg were randomly selected at random. The skin temperature 5 min after injection. The change of skin temperature in the block side and the non-block side was the difference of the skin temperature before and after injection, and the calibrated change value of the skin temperature of the block side was T _ corrected. Results: there were 232 measuring points on each side, T1. 8 鹵0. 5) 鈩，

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