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目的：探讨彩色多普勒超声定位锁骨上臂丛神经阻滞在上肢骨科手术的应用价值。方法：选择2012 年5 月-2013 年12 月行锁骨上臂丛神经阻滞麻醉的上肢骨科手术患者120 例，根据锁骨上臂丛定位方法的不同分为对照组和观察组，每组60 例，观察组选择彩色多普勒超声定位锁骨上臂丛神经，对照组选择和传统手法解剖学定位，比较两组患者麻醉操作时间、麻醉显效时间、持续时间，麻醉优良率及并发症情况。结果：①观察组操作时间、麻醉显效时间分别为（192.5± 23.86）s，（10.45± 2.39）min，较对照组的（227.75± 26.18）s，（15.36± 4.85）min 短，两组比较差异有统计学意义（t1=48.34，P1=0.015；t2=6.28，P2=0.022）；②观察组麻醉优良率为100%，明显高于对照组的86.67%，两组比较差异有统计学意义（x2=9.12，P=0.041）；③观察组患者无并发症发生，对照组2 例并发皮下血肿，1 例药物毒性反应，1 例交感神经阻滞，并发症发生率为8.33%，两组比较并发症发生率差异有统计学意义（x2=8. 34，P=0.049）。结论：彩色多普勒超声定位锁骨上臂丛神经阻滞操作时间短、显效快、持续时间长，麻醉优良率高，安全性高，值得临床推广应用。

英文摘要:

Objective:To investigate the value of the color Doppler ultrasound in locating infraclavicular brachial plexus block in the upper extremity orthopedic surgery.Methods:120 patients subjected to supraclavicular brachial plexus block anesthesia of the upper extremity orthopedic surgery from May 2012 to December 2013 were chosen and were divided into the control group (n=60) and observation group (n=60) depending on the supraclavicular brachial positioning methods. The observation group used color Doppler ultrasound to locate the brachial plexus nerves clavicle while the control group was given traditional practices anatomical location. The operating hours, anesthesia onset time, duration, and complications of anesthesia excellent rate between the two groups were compared.Results:①The operating time, effective time of anesthesia of the observation group were (192.5± 23.86) s, (10.45± 2.39) min, shorter than (227.75± 26.18) s, (15.36± 4.85) min in the control group, and the difference was statistically significant (t1=48.34, P1=0.015;t2=6. 28, P2=0.022); ② Excellent and good rate of the observation group was 100%,significantly higher than that of the control group(86.67%), the difference was statistically significant (x2= 9.12, P=0.041) ; ③The patients in the observation group had no complications, but there were 2 cases of hematoma, one case of drug toxicity, one case of sympathetic block in the control group, with a complication rate of 8.33 %. The complications incidence had significant difference between the two groups (x2=8.34, P=0.049).Conclusion:Collarbone brachial plexus block on the base of color Doppler ultrasound location presents short operation time ,markedly faster, longer duration of anesthesia and higher excellent rate, which proves that it is safe and worth to be applied in clinic.

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