本文選題：股神經(jīng)阻滯 + 坐骨神經(jīng)阻滯��； 參考：《鄭州大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年03期

【摘要】：目的:探討皮膚溫度(皮溫)變化對(duì)感覺(jué)缺失區(qū)域神經(jīng)阻滯效果的評(píng)估價(jià)值。方法:選擇擇期行下肢肌痙攣松解手術(shù)的截癱患者58例,在手術(shù)側(cè)行超聲引導(dǎo)下單側(cè)股神經(jīng)+坐骨神經(jīng)阻滯,股神經(jīng)周?chē)⑸?.5 mg/L羅哌卡因15 mL,坐骨神經(jīng)周?chē)⑸?.0 mg/L羅哌卡因10 mL。隨機(jī)在兩側(cè)下肢股神經(jīng)支配的股內(nèi)側(cè)肌區(qū)域、隱神經(jīng)支配的小腿內(nèi)側(cè)區(qū)域、坐骨神經(jīng)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(gè)測(cè)量點(diǎn),記錄注藥前、注藥后5 min的皮溫。阻滯側(cè)和非阻滯側(cè)皮溫變化值(T_阻和T_非)為注藥前后皮溫的差值,校準(zhǔn)的阻滯側(cè)皮溫變化值(T_校)=T_阻-T_非。結(jié)果:兩側(cè)各有232個(gè)測(cè)量點(diǎn),T_阻=-(1.8±0.5)℃,T_非=-(0.5±0.3)℃,T_校=-(1.2±0.6)℃。其中阻滯側(cè)202個(gè)點(diǎn)神經(jīng)阻滯效果佳,30個(gè)點(diǎn)神經(jīng)阻滯效果差。T_校與神經(jīng)阻滯效果呈較強(qiáng)的負(fù)相關(guān)關(guān)系(r_S=-0.758,95%CI=-0.790~-0.572)。以T_校對(duì)神經(jīng)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(shí)的診斷敏感度達(dá)83.3%,特異度達(dá)81.7%。結(jié)論:皮溫變化是評(píng)估皮膚感覺(jué)缺失情況下神經(jīng)阻滯效果的有價(jià)值指標(biāo)。
[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，

本文編號(hào)：1909291