| 高媛媛,张 鹏,张海鹰,周荣胜,王 璐.斜角肌间臂丛阻滞影响心率变异性的危险因素分析[J].,2023,(5):909-913 |
| 斜角肌间臂丛阻滞影响心率变异性的危险因素分析 |
| Risk Factors of Interscalenus Brachial Plexus Block Affecting Heart Rate Variability |
| 投稿时间：2022-06-06 修订日期：2022-06-30 |
| DOI：10.13241/j.cnki.pmb.2023.05.021 |
| 中文关键词: 斜角肌间臂丛阻滞 心率变异性 危险因素 |
| 英文关键词: Interscalenus brachial plexus block Heart rate variability Risk factors |
| 基金项目:国家自然科学基金项目（81273902） |
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| 中文摘要: |
| 摘要 目的：本研究旨在探讨斜角肌间臂丛阻滞影响心率变异性的危险因素及Logistic回归分析。方法：选取2021年5月至2022年3月于我院接受肩关节开放手术治疗的患者60例作为研究对象，按照麻醉方式不同随机分为实验组和对照组2组，其中实验组患者给与超声引导下斜角肌间臂丛神经阻滞，对照组患者进行单纯斜角肌间臂丛神经阻滞，统计患者的一般临床资料，对比分析阻滞前后心率变异指标、SpO2、心率和平均动脉压水平；同时研究危险因素与心率变异性之间的关系。结果：斜角肌间臂丛阻滞影响心率变异性的单因素分析显示，危险因素与性别、平均年龄、BMI、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、合并慢性病（糖尿病、高血压）、吸烟史和饮酒史无关（P>0.05），镇痛维持时间较短、运动恢复时间较长、阻断节数较少的斜角肌间臂丛阻滞患者更易表现出心率变异性（P<0.05）。阻滞后，实验组LF、HF、LF/HF、RMSSD、SDNN和PNN50 %显著低于对照组（P<0.05），而阻滞后SpO2、心率和平均动脉压比较无差异（P>0.05）。影响心率变异性危险因素的多因素为镇痛维持时间（OR=6.224，P=0.001<0.05）、运动恢复时间（OR=9.556，P=0.002<0.05）、阻断节数（OR=7.591，P=0.001<0.05）。结论：斜角肌间臂丛阻滞出现心率变异性与镇痛维持时间、运动恢复时间、阻断节数有关。 |
| 英文摘要: |
| ABSTRACT Objective: The purpose of this study was to investigate the risk factors and Logistic regression analysis of interscalenus brachial plexus block affecting heart rate variability. Methods: Selection in May 2021 to March 2022 in our hospital in patients with shoulder joint open surgical treatment of 60 cases as the research object, according to the different anesthesia were randomly divided into experimental group and control group in two groups, one group patients give between scalene muscle under the guidance of ultrasound brachial plexus block, between the control group patients with pure scalenus brachial plexus block. General clinical data of the patients were collected, and heart rate variation index, SpO2, heart rate and mean arterial pressure level before and after block were compared and analyzed. The relationship between risk factors and heart rate variability was also studied. Results: Univariate analysis of interbrachial plexus block affecting heart rate variability showed that risk factors were not related with sex, mean age, BMI, total cholesterol, triglycerides, HDL, LDL, chronic diseases (diabetes, hypertension), smoking and alcohol history(P>0.05), and interanginal brachial plexus block with shorter analgesic maintenance, longer exercise recovery and fewer blocks were more likely to show heart rate variability (P<0.05). After the block, LF, HF, LF / HF, RMSSD, SDNN and PNN50% were significantly lower than those in the control group(P<0.05), however, there was no difference in SpO2, heart rate, and mean arterial pressure after the block(P>0.05). The multiple factors affecting the risk factors of HEART rate variability were maintenance time of analgesia (OR=6.224, P=0.001<0.05), exercise recovery time (OR=9.556, P=0.002<0.05), number of blocks (OR=7.591, P=0.001<0.05). Conclusion: The heart rate variability in brachial plexus block was related to the maintenance time of analgesia, the recovery time of exercise and the number of blocks. |
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