陈汉强　孙立夫　沈娟萍浙江省桐乡市第二人民医院麻醉科，浙江桐乡　314511

陈汉强孙立夫沈娟萍
浙江省桐乡市第二人民医院麻醉科，浙江桐乡314511

目的分析超声联合神经刺激仪引导腘窝坐骨神经、股神经和隐神经阻滞的临床效果。方法 选择2013年10月～2015年10月我院收治的需进行膝部以下手术的患者66例，采用随机数字表法分为实验组和对照组；对照组采用阻滞腘窝坐骨神经、股神经的方式，实验组采用超声联合神经刺激仪引导腘窝坐骨神经、股神经阻滞的方式，比较两组临床效果。结果两组在操作时间方面，实验组手术时间稍长于对照组手术时间，但差异无统计学意义（P＞0.05），实验组起效时间（5.64±1.76）min明显短于对照组（13.29±2.99）min；比较两组镇痛效果满意情况，实验组满意率100.00%，明显高于对照组的84.85%；实验组不良反应发生率6.06%，明显低于对照组的24.24%，差异有统计学意义（P＜0.05）。结论 采用超声联合神经刺激仪引导腘窝坐骨神经、股神经和隐神经阻滞具有操作简单、镇痛起效快、镇痛效果好、不良反应少的优势，对提高患者镇痛满意度、促进医患关系和谐有积极意义，作为一种更好的麻醉选择方式值得临床推广。

超声联合神经刺激仪；腘窝坐骨神经；股神经和隐神经阻滞

[Abstract]Objective To analyze the clinical effects of ultrasound combined with nerve simulator guided nerve block of sciatic nerve,femoral nerve and saphenous nerve.Methods 66 patients who were admitted to our hospital from October 2013 to October 2015 and were in need of the surgery under the knee were selected.They were assigned to the experiment group and the control group according to the random number table.The control group was given the approach of nerve block of sciatic nerve and femoral nerve,and the experiment group was given the approach of ultrasound combined with nerve stimulator guided nerve block of sciatic nerve,femoral nerve and saphenous nerve.The clinical effects were compared between the two groups.Results In terms of operating time,the surgery time in the experiment group was slightly longer than that in the control group,but the differences were not significant(P>0.05).The onset time in the experiment group was(5.64±1.76)min,significantly shorter than that of(13.29±2.99)in the control group.The satisfaction degree of analgesic effect was compared between the two groups.The satisfaction rate in the experiment group was 100.00%,significantly higher than that of 84.85%in the control group.The incidence rate of adverse reactions in the experiment group was 6.06%,significantly lower than that of 24.24%in the control group.The differences were statistically significant(P<0.05).Conclusion The application of ultrasound combined with nerve simulator guided nerve block of sciatic nerve,femoral nerve and saphenous nerve has the advantages of simple operation,fast onset of analgesic effect, better analgesic effect and fewer adverse reactions.It has positive significance of improving patients'analgesia satisfaction degree,and promoting a harmonized doctor-patient relationship,which is worthy of clinical promotion as a better approach of anesthesia.

[Key words]Ultrasound combined with nerve stimulator;Sciatic nerve;Femoral nerve and saphenous nerve

医疗水平的进步，人们的平均寿命在增加，老龄化已经成为社会共同关注的话题。随之而来的各种疾病问题也引发医疗界关注[1]。特别是关节问题，由于术后会引发患者剧烈的疼痛，导致患者调节反应迟钝、生理机能降低，严重的甚至会引发静脉血栓等并发症。为……