摘要
目的观察连续臂丛阻滞术后自控镇痛对断指再植术后肢体的保护作用。方法对80例上肢单指完全离断伤行断指再植病人,随机分为两组,每组40例,A组为连续臂丛阻滞镇痛组:B组不行镇痛。观察两组分别于麻醉前1h(T1),手术后4h(T2),12h(T3),24h(T4)四个时段抽取肘静脉血测定丙二醛(MDA)、谷胱甘肽(GSH)及超氧化物歧化酶(SOD)血浆浓度。结果手术前1h(T1)两组MDA、GSH、SOD无明显差异;与T1相比,A组MDA在T2、T3、T4时显著降低(P<0.01),GSH、SOD均显著增高(P<0.01);与A组比较,B组T2、T3、T4时MDA均显著增高(P<0.01),GSH、SOD则显著降低(P<0.01)。结论连续臂丛阻滞术后自控镇痛能够有效地预防肢体缺血再灌注损伤,可有效保护断肢再植术后肢体。
Objective To observe the effect of continuous postoperative patient - controlled analgesia using brachial plexus block on protecting the finger after replantaion. Methods 80 patients who suffer from finger separation were randomly divided into two groups. Group A received continuous postoperative patient - controlled analgesia, Group B was control group. Before anesthesia 1 hour （ T1 ）, postopertive 4 hours （ T2 ）, 12 hours （ T3 ） ,24 hours （ T4）, two group drawn venous blood to test concentration of malondialdehyde （MDA）, glutathione （GSH） and superoxide dismutase（SOD）. Results There was no significant difference between two groups in MDA, GSH and SOD before operation. For group A, MDA decreased significantly in T2, T3, T4（p 〈0. 01 ）, but GSH and SOD increased significantly（p 〈0. 01 ）. For group B, MDA increased significantly in T2, T3, T4 （p 〈 0. 01 ）, but GSH and SOD decreased significantly（p 〈0. 01）. Conclusion Continuous postoperative patient - controlled analgesia using braehial plexus block can effectively prevent finger from ischemia - reperfusion injury and protect the finger after replantaion.
出处
《现代医院》
2012年第3期39-40,共2页
Modern Hospitals
关键词
缺血再灌注损伤
自控镇痛
臂丛阻滞
断指再植
lschemia- reperfusion injury, Patient- controlled analgesia, Brachial plexus block, Replata-lion
