| 完全清醒技术在腕管综合征手术中的应用 |
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投稿时间：2019-07-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 秦宏玖 |
QIN Hong-jiu |
皖南医学院弋矶山医院手足外科, 安徽 芜湖 241000 |
Department of Hand and Foot Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241000, Anhui, China |
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| 夏江 |
XIA Jiang |
皖南医学院弋矶山医院手足外科, 安徽 芜湖 241000 |
Department of Hand and Foot Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241000, Anhui, China |
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| 马涛 |
MA Tao |
皖南医学院弋矶山医院手足外科, 安徽 芜湖 241000 |
Department of Hand and Foot Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241000, Anhui, China |
woshilkxiaoqiang@outlook.com |
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| 期刊信息：《中国骨伤》2020年，第33卷，第7期，第659-661页 |
| DOI：10.12200/j.issn.1003-0034.2020.07.013 |
| 基金项目: |
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中文摘要:
目的： 探讨完全清醒（wide awake）无止血带局部止血麻醉技术在双侧腕管综合征手术中的临床应用及其疗效。
方法： 自2016年3月至2018年8月采用完全清醒技术治疗双侧腕管综合征患者20例（40侧），均为女性，年龄32~56（50.8±6.4）岁。评估麻醉、术中和术后的焦虑与疼痛情况，术中评估术野出血情况，术后观察术区的皮肤愈合和麻醉不良反应，并采用Kelly分级进行功能恢复情况评价。
结果： 20例患者获得随访，时间6~9个月，平均7.8个月。麻醉注射前有一定的焦虑（NRS评分1~3分），麻醉注射时仅第1针轻度疼痛（NRS评分2~3分）；术中操作无疼痛及焦虑（NRS评分0分）；术后无焦虑（NRS评分0分），有轻到中度疼痛（NRS评分1~6分）。术后术区皮肤均Ⅰ期愈合，无麻醉不良反应。术后根据Kelly分级评定疗效：优30侧，良8侧，可2侧。
结论： 完全清醒技术应用于双侧腕管综合征的松解手术安全有效，可取得较好的临床效果。 |
| 【关键词】麻醉 神经卡压综合征 关节囊松解 |
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| Clinical application of wide awake technique in carpal tunnel syndrome |
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ABSTRACT
Objective: To explore the application and clinical effect of wide awake local anesthesia no tourniquet technique in the surgery of bilateral carpal tunnel syndrome.
Methods: From March 2016 to August 2018,20 patients(40 sides) with bilateral carpal tunnel syndrome were treated by wide awake technique. All patients were female,aged from 32 to 56(50.8±6.4) years old. The anesthetic,intraoperative and postoperative pain and anxiety were evaluated,operative field bleeding in operation were assessed,postoperative skin healing of surgical area and anesthetic complications were observed,and Kelly grading were used to evaluate recovery of function.
Results: Twenty patients were followed up from 6 to 9 months with an average of 7.8 months. There was light anxiety before injection(NRS score ranged from 1 to 3),slight pain occurred during injection on the first poke(NRS ranged from 2 to 3);no pain and anxiety during operation(NRS score was 0);mild or moderate pain (NRS score ranged from 1 to 6) without anxiety(NRS score was 0) after operation was occurred. Surgical skin healed well at the stageⅠwithout side effect of anesthetic. At final follow-up,according to Kelly grading,30 sides got excellent results,8 sides good and 2 sides fair.
Conclusion: Wide awake technique is safe and effective in treating neurolysis of bilateral carpal tunnel syndrome,and could receive good clinical effects. |
| KEY WORDS Anesthesia Nerve compression syndromes Joint capsule release |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 秦宏玖,夏江,马涛.完全清醒技术在腕管综合征手术中的应用[J].中国骨伤,2020,33(7):659~661 |
| 英文格式: | QIN Hong-jiu,XIA Jiang,MA Tao.Clinical application of wide awake technique in carpal tunnel syndrome[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(7):659~661 |
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