锁骨上入路臂丛神经阻滞技术体系：精准阻滞已向临床迈进

罗雀华; 陈亮; 舒海华; 姚伟锋

doi:10.3969/j.issn.1006-5725.2023.16.001

实用医学杂志 >

2023 , Vol. 39 >Issue 16: 2013 - 2016

DOI: https://doi.org/10.3969/j.issn.1006-5725.2023.16.001

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锁骨上入路臂丛神经阻滞技术体系：精准阻滞已向临床迈进

罗雀华 ,
陈亮 ,
舒海华 ,
姚伟锋

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^1.南方医科大学附属广东省人民医院（广东省医学科学院），麻醉科，（广州 510080 ）
^2.南方医科大学附属广东省人民医院（广东省医学科学院），医务科，（广州 510080 ）
^3.中山大学附属第三医院麻醉科（广州 510630 ）

姚伟锋，博士，副主任医师，博士研究生导师，中山大学附属第三医院手术麻醉中心副主任，心胸大血管麻醉专科主任。兼任广东省医学会麻醉学分会秘书；广东省医学会麻醉学分会青委会副主委等学术兼职。研究方向：肝脏移植围术期器官损伤机制及保护策略研究；精准麻醉和疼痛管理。主持包括国自然面上项目在内的8项基金项目，是中山三院第一批重大人才工程培育计划项目中青年杰出人才，另外参与11项国家自然科学基金项目及6项省部级项目；目前发表SCI收录论文61篇，第一作者及通信作者论文47篇，中国科学院一区论文12篇。并作为《Medical Gas Research》、《麻醉安全与质控》等多个学术期刊的审稿人及编委；参编《围术期标准数据集》、《围手术期器官功能评估与麻醉决策》、《小儿肝移植术麻醉管理专家共识》等书籍。

收稿日期: 2023-06-15

网络出版日期: 2023-08-25

基金资助

国家自然科学基金项目(81974081);广东省医学科研基金项目(A2020015);广东省中医药局科研项目(20231009);广东省麻醉医学临床医学研究中心建设项目(2023B110006)

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Supraclavicular brachial plexus blocks technique system： precise blocks have advanced to clinical practice

Quehua LUO ,
Liang CHEN ,
Haihua SHU ,
Weifeng. YAO

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Department of Anesthesiology，Guangdong Provincial People′s Hospital （Guangdong Academy of Medical Sciences），Southern Medical University，Guangzhou 510080，China

Received date: 2023-06-15

Online published: 2023-08-25

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摘要

锁骨上入路臂丛神经阻滞是上肢手术麻醉和镇痛的常用技术。近年来，超声使臂丛神经轨迹、筋膜层次和周围解剖标记可视化，在此基础上通过规范的扫描和成像、穿刺和注药方法，形成精准锁骨上入路臂丛神经阻滞技术体系。然而，临床应用精准锁骨上入路臂丛神经阻滞技术处于起步阶段，神经内注射风险、膈神经麻痹、阻滞动力学数据缺乏等是限制其临床应用的难点和痛点。本文着重从解剖基础、入路和技术特点和临床应用如肩关节镜手术进行系统阐述，以期提高麻醉医师对该精准技术体系的认识并促进其临床应用。

关键词： 锁骨上入路; 臂丛神经阻滞; 超声; 肩关节镜手术

本文引用格式

罗雀华 , 陈亮 , 舒海华 , 姚伟锋 . 锁骨上入路臂丛神经阻滞技术体系：精准阻滞已向临床迈进[J]. 实用医学杂志, 2023 , 39(16) : 2013 -2016 . DOI: 10.3969/j.issn.1006-5725.2023.16.001

Abstract

Supraclavicular brachial plexus block is a commonly used technique for upper limb anesthesia and analgesia. Recently， ultrasound can visualize the trajectory of the brachial plexus， surrounding fascia and anatomical markers， among which standardized scanning and imaging， needle techniques and drug injection methods gradually formed a precise supraclavicular block technique system. However， the application and promotion of precise supraclavicular blocks are in their infancy， risk of intraneural injection， phrenic paralysis， and lack of block dynamics are still difficult and painful points in clinical anesthesia practice. To improve the anesthesiologists' understanding of these techniques and promote their clinical application， this paper focuses on its anatomical basis， approach， and technical characteristics as well as their application in arthroscopic shoulder surgery.

Key words： supraclavicular; brachial plexus block; ultrasound; arthroscopic shoulder surgery

参考文献

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