2种骶裂孔穿刺方法的骶管麻醉效果比较

发布时间：2018-03-06 05:22

本文选题：骶管麻醉　切入点：B超引导法　出处：《中国现代医学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的探索B超定位引导骶裂孔穿刺法和传统体表定位法穿刺骶管麻醉的成功率与并发症。方法选取该院肛肠科和泌尿外科97例会阴部手术患者,随机分为两组,观察组(B超定位)51例,对照组(传统方法)46例。观察组采取线性高频B超探头纵横十字交叉法定位。探及骶裂孔后,将纵置的探头下部置于骶裂孔上方,采用声场内平面技术,将注射针头经超声探头下缘,与皮肤呈45°角缓慢进针。根据超声实时显像图像,引导和调整穿刺方向及深度,直至针尖完全位于骶管腔中。对照组采取传统体表定位法穿刺。结果观察组一次穿刺成功率、血管损伤率、穿刺次数及穿刺时间与对照组比较,差异有统计学意义(P0.05)。观察组1例穿刺失败,是因为初次实施B超定位穿刺时,未注意避开静脉丛,导致血管损伤。结论 B超引导下骶管麻醉,不但大大提高穿刺成功率,而且节约操作时间,减少穿刺次数,减少血管损伤并发症,有很好的临床推广应用价值。
[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 掳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.
【作者单位】：南京中医药大学附属连云港市中医院麻醉科;
【分类号】：R614

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