吉林大学学报(医学版) ›› 2018, Vol. 44 ›› Issue (03): 610-614.doi: 10.13481/j.1671-587x.20180328

• 临床医学 • 上一篇    下一篇

改良腱鞘麻醉在小儿手外伤治疗中的临床应用

许可1, 王斌1, 刘钦毅2, 张为众1   

  1. 1. 吉林大学中日联谊医院手外科, 吉林 长春 130033;
    2. 吉林大学第二医院脊柱外科, 吉林 长春 130041
  • 收稿日期:2018-01-29 出版日期:2018-05-28 发布日期:2018-05-31
  • 通讯作者: 张为众,副教授,副主任医师,硕士研究生导师(Tel:0431-84997863,E-mail:zwz@jlu.edu.cn) E-mail:zwz@jlu.edu.cn
  • 作者简介:许可(1990-),男,内蒙古自治区包头市人,在读医学硕士,主要从事手外科疾病诊治方面的研究。
  • 基金资助:
    国家自然科学基金面上项目资助课题(81672263)

Clinical application of modified transthecal digital block in treatment of handtrauma in children

XU Ke1, WANG Bin1, LIU Qinyi2, ZHANG Weizhong1   

  1. 1. Department of Hand Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, China;
    2. Department of Spinal Surgery, Second Hospital, Jilin University, Changchun 130041, China
  • Received:2018-01-29 Online:2018-05-28 Published:2018-05-31

摘要: 目的:探讨改良腱鞘麻醉在小儿手外伤治疗中的优越性及其临床应用价值,为临床小儿手术麻醉方法的选择提供参考。方法:选择接受急、慢诊手部手术患儿102例(104指)。采用随机数表法将患儿分为传统指根神经阻滞麻醉组(54例,54指)和改良腱鞘麻醉组(48例,50指)。完成麻醉后5min内间隔1min对4个部位采用FLACC评分法(<7岁)或视觉模拟评分(VAS)法(7~18岁)进行痛觉检测,注射后5min内疼痛评分为0则表示麻醉成功。5min以后患儿仍然感觉疼痛无法接受手术为麻醉失败,改用传统指神经阻滞麻醉完成手术。检测2组患儿麻醉成功率、麻醉起效时间、麻醉持续时间以及麻醉药剂量。结果:改良腱鞘麻醉组和传统指根神经阻滞麻醉组患儿麻醉成功率比较差异无统计学意义(P>0.05)。与传统指根神经阻滞麻醉组比较,改良腱鞘麻醉组患儿麻醉平均起效时间缩短(P<0.05),平均麻醉药剂量减少(P<0.05)。结论:改良腱鞘麻醉具有使用麻醉药剂量小、麻醉起效快、操作简便和患儿痛苦小等优点,适用于小儿手外伤的麻醉。

关键词: 改良腱鞘麻醉, 传统指根神经阻滞麻醉, 儿童, 手外伤

Abstract: Objective: To probe the advantages and clinical application value of modified transthecal digital block in the treatment of hand trauma in the children,and to provide the references for the selection of anesthesia methods for surgery. Methods: A total of 102 patients (104 digits) required acute or chronic hand surgery were selected.The patients were divided into two groups by the method of random number table,54 patients(54 fingers) were treated with traditional digital block(traditional digital block group),and 48 patients (50 fingers) were anesthetized with modified transthecal digital block(modified transthecal digital block group).The pain detection was performed on the 4 sites within 5 min after anesthesia by using the method of Face,Legs,Activity,Cry,Consolability Behavioral Tool(FLACC)(<7 years old) or Visual Analogue Scale(VAS)(7-18 years old).The 0 score of pain meant that the anesthesia was successful in 5 min after injection.After 5 min,if the child still felt painful and unable to undergo surgery,it was marked as failure,and the method of traditional digital block was used to complete the operation.The successful rate,the onset time,the duration time,and the dose of anesthetic drugs of the patients in two groups were detected. Results: The successful rate of the patients in modified transthecal digital block group had no significantly difference compared with traditional digital block group (P>0.05).Compared with traditional digital block group,the average onset time of anesthetic drug of the patients in modified transthecal digital block group was shortened (P<0.05),and the average dose of anesthetic drug was decreased (P<0.05). Conclusion: The modified transthecal digital block has the advantages of smaller dose,quicker effect,easier operation,and less pain.It is suitable for the clinical application in the treatment of hand trauma in the pediatric patients.

Key words: children, traditional digital block, modified transthecal digital block, hand trauma

中图分类号: 

  • R681.7