Shoulder surface temperature and bone scintigraphy findings in patients with rotator cuff tears

Background

Complex regional pain syndrome (CRPS) is one of the serious complications after surgical treatment of a rotator cuff tear. Both a measurement of body surface temperature and bone scintigraphy have been used as diagnostic tools for the early phase of CRPS.Unfortunately, few studies have been carried out that applied these methods to the patients after rotator cuff repair.

Purposes

To clarify both shoulder surface temperature and bone scintigraphy findings in patients with rotator cuff tears.

Subjects and methods

Subjects comprised patients with unilateral rotator cuff tears (five men and five women, mean age 61 years). For measurements of shoulder surface temperature, a Thermochron was attached to both shoulders. As for bone scintigraphy, intravenous injection of technetium-labelled hydroxymethylenebisphosphonic acid (99mTc-HMDP)was performed, and then images were taken with a gamma camera.

Results

During the measurements, the changes in body surface temperature for the affected and healthy shoulders remained within the standard deviation of the reference group. The intensity of radioisotope (RI) uptake for the affected shoulder joint was significantly increased compared to that for the healthy shoulder joint (P < 0.05).

Conclusion

RI uptake is increased in shoulders with rotator cuff tears, whereas shoulder surface temperature shows no differences on the affected and unaffected sides.     

MR Geyser Sign in chronic rotator cuff tears

Acromio-clavicular (AC) joint cysts are rare presentation of chronic shoulder pathology. These cysts may be observed secondary to either degenerative changes in the AC joint with an intact rotator cuff (type 1 cyst) or following a chronic rotator cuff tear (type 2 cyst). The latter phenomenon is known as Geyser Sign and is described by ultrasound, conventional arthrogram and magnetic resonance imaging (MRI). We present a case of chronic rotator cuff tear presenting with a large type 2 cyst and Geyser Sign on MRI.     

肩关节镜下肩袖修复术后I型复杂区域疼痛综合征的危险因素分析

目的 探讨肩关节镜下肩袖修复术后发生I型复杂区域疼痛综合征的危险因素。方法 选取2018年1月—2020年10月在湖南省人民医院骨科因肩袖损伤行肩关节镜下肩袖修复术的346例患者,术后发生I型复杂区域疼痛综合征的32例患者为观察组,未发生的314例患者为对照组。比较两组患者的性别构成、年龄、优势侧、冠心病、高血压、糖尿病、颈椎病、高血脂、损伤原因、美国加州大学（UCLA）肩关节评分、视觉模拟评分法（VAS）、Goutallier肩袖肌肉脂肪浸润分型、关节各方向主动活动度和被动活动度、手术时间、住院时间、麻醉方式、撕裂肌腱类型、缝合方式、钙化性肌腱炎、肩峰下滑膜清理、肩峰成型、肱二头肌长头腱切断、Cofield肩袖损伤分型、锚钉数量及缝合肌腱数量;采用多因素Logistic回归分析肩关节镜下肩袖修复术后发生I型复杂区域疼痛综合征的危险因素。结果 两组的性别构成、术前VAS评分、术前UCLA肩关节评分（疼痛部分）、Cofield肩袖损伤分型及Goutallier肩袖肌肉脂肪浸润分型比较,差异有统计学意义（P <0.05）。多因素Logistic回归分析显示,女性［O^R=3.653（95% CI：1.200,11.121）］、术前高VAS评分［O^R=1.609（95% CI：1.115,2.323）］均为肩关节镜下肩袖修复术后发生I型复杂区域疼痛综合征的危险因素（P <0.05）;肩袖小撕裂［O^R=0.177（95% CI：0.038,0.825）］是肩关节镜下肩袖修复术后发生I型复杂区域疼痛综合征的保护因素（P <0.05）。结论 女性患者及术前疼痛度高的患者肩关节镜下肩袖修复术后发生I型复杂区域疼痛综合征的风险较高,肩袖小撕裂的患者肩关节镜下肩袖修复术后发生I型复杂区域疼痛综合征的风险较低。肩关节镜下肩袖修复术前应评估上述因素,及早采取应对与干预措施。     

关节镜下部分修补老年性巨大肩袖损伤

目的 探讨关节镜下部分修补老年性巨大肩袖损伤的临床效果。方法 回顾性分析2012年1月至2014年6月关节镜下部分修补老年性巨大肩袖损伤的患者58例,其中男27例,女31例;左侧11例,右侧47例,平均年龄57.5岁。应用美国肩肘外科医师评分（American Shoulder and Elbow Surgeons,ASES）、Constant-Murley肩关节功能评分、美国加利福尼亚大学洛杉矶分校（University of California,Los Angeles,UCLA）评分记录术前及术后最终随访时的肩关节疼痛、肩关节活动范围、前屈上举肌力、外展强度的情况。结果 58例患者均获得有效随访,患者术程顺利,术后获18~26个月（平均23.2个月）随访。术前ASES评分为（8.2±1.4）分,Constant评分为（37.1±7.2）分,UCLA评分为（8.7±2.5）分;术后18个月ASES评分为（28.5±4.5）分,Constant评分为（84.6±4.7）分,UCLA评分为（28.4±4.5）分。术后18个月与术前比较,差异有统计学意义（P<0.05）。结论 关节镜下部分修补老年性巨大肩袖损伤的治疗效果满意,可获得良好的肩关节功能。     

肩袖全层撕裂中分层与非分层撕裂的MRI征象对比研究

目的：对比分析肩袖全层撕裂中分层与非分层撕裂的MRI表现。方法：回顾性分析243 例肩袖全层撕裂患者,根据撕裂类型及肌腱回缩距离分为病例1组、病例2组及对照组,记录撕裂口大小、肌腱回缩距离及冈上、冈下肌腹萎缩程度,根据数据分布类型,采用单因素方差分析或Kruscal-Wallis检验比较3组撕裂口大小、肌腱回缩距离及冈上、冈下肌腹萎缩程度。结果：243例肩袖全层撕裂患者中,分层撕裂145例（占59.7%）。病例2组滑囊侧肌腱回缩距离[（22.2±9.8）mm]与对照组[（29.7±12.0）mm]和病例1组 [（29.0±12.5）mm]比较差异有统计学意义（P ＜0.01）;病例2组关节侧肌腱回缩距离[（35.1±11.7）mm]与对照组[（29.7±12.0）mm]和病例1组[（29.0±12.5）mm]比较差异有统计学意义（P ＜0.01）,3组间撕裂口大小、肌腹萎缩程度比较差异无统计学意义。结论：肩袖全层撕裂中分层撕裂较非层撕裂常见,不同分型中关节侧及滑囊侧肌腱回缩距离存在差异,肩袖修补术前,应充分认识分层撕裂的存在及类型,以确保损伤肩袖得以完整修复。     

188例肩袖损伤的关节镜疗效分析

目的：总结关节镜治疗肩袖损伤的疗效.方法：回顾性分析2005年5月至2010年5月广东省佛山市南海区人民医院收治的188例肩袖损伤患者的临床资料,观察关节镜下微创治疗肩袖损伤的疗效.结果：随访1年以上,188例患者中完全缓解138例（73.4％）、部分缓解28例（14.9％）、未缓解22例（11.7％）.结论：通过及时而准确的诊断,并按病情采用相应的术式,关节镜治疗肩袖损伤的疗效较好.     

关节镜下保留二头肌肌腱转位固定术治疗巨大肩袖撕裂的疗效分析

目的??研究关节镜下保留二头肌肌腱转位固定术治疗巨大肩袖撕裂。方法??2014 年 1 月—2017 年 5 月对 39 例巨大肩袖撕裂患者施行保留肱二头肌长头腱的肌腱转位固定术。术前与术后 6 个月进行 Constant- Murley 肩关节评分、 加利福尼亚大学洛杉矶分校（UCLA）肩关节评分。结果??患者手术顺利, 术前 Constant- Murley 肩关节评分为（28.07±7.48） ,UCLA 肩关节评分为（17.8±2.6） ; 术后 6 个月随访 Constant‐Murley 肩关节评分为（72.02±6.38） ,UCLA 肩关节评分为（30.5±2.4） 。术后 Constant-Murley 肩关节评分、UCLA 肩关节评分与术前比较,差异有统计学意义（ P <0.05） 。术后患者疼痛缓解,未出现复发。结论??关节镜下保 留二头肌肌腱转位固定术治疗巨大肩袖撕裂临床效果满意。     

The clinical results of lower trapezius tendon transfer with the peroneus longus allograft augmentation combined with interpositional repair with fascia lata in massive irreparable rotator cuff tears

Objectives:To investigate the clinical results of lower trapezius (LT) tendon transfer and interpositional repair that were performed simultaneously in patients with massive irreparable rotator cuff tears.Methods:Between 2018 and 2020 years, 16 patients with massive irreparable rotator cuff tears that were treated with LT tendon transfer and interpositional repair at the same time were included in this study. The mean follow-up period was 29±3 months (24-39 months) and the mean age of patients was 62±9 years (42-73 years). The acromio-humeral distance, active range of motions, Visual Analog Scale (VAS) scores, University of California-Los Angeles (UCLA) scores and Constant-Murley scores were made preoperatively and at the final follow-up.Results:At the final follow-up, forward flexion was increased from 109˚±24.7 to 144˚±22.21 (p=0.005), abduction from 60˚±16.33 to 135˚±16.33 (p=0.005) and external rotation from 12˚±16.87 to 35˚±14.34 (p=0.005). Total UCLA scores were 5.9±2.13 to 22.7±5.29 (p=0.005), Constant-Murley scores were 24±9.43 to 50.2±14.28 (p=0.008), VAS scores were 6.1±1.1 to 2.4±1.35 (p=0.007), mean acromio-humeral distances were 4.64±0.85 mm (3.42-6.23 mm) to 6.58 mm (5.25-8.21 mm) (p=0.005) preoperatively and at the final follow-up. Except one patient who had a frozen shoulder any significant complication was detected.Conclusion:Adding interpositional repair to the LT tendon transfer in patients with posterior superior irreparable rotator cuff tear seems to have satisfactory short to mid-term clinical outcomes without an increase in complications.     

Changes with time in skin temperature of the shoulders in healthy controls and a patient with shoulder-hand syndrome

Background

Abnormal skin temperature in the shoulder is caused by various diseases. A thermography is unable to capture temperature changes over time. In contrast, a Thermocron is an effective measuring device to monitor temperature changes over time.

Purposes

The purposes of this study employing a Thermocron were to measure shoulder skin temperature over time in healthy subjects and to detect shoulder skin temperature abnormalities in a patient with shoulder-hand syndrome.

Subjects and methods

Subjects comprised 10 healthy volunteers (20 shoulders; 4 men and 6 women, mean age 54 years). For measurements, a Thermocron was attached on both shoulders. Measurements were made from 21.00 to 07.00 the following morning at 15-minute intervals.

Results

Gradual difference in right and left shoulder skin temperature was observed with the timing of measurements but no significant difference was apparent, i.e. dominant side 34.9 ± 0.8°C, non-dominant side 34.9 ± 0.9°C (P = 0.28).

Presentation of a case with shoulder-hand syndrome

A 54-year-old woman with the diagnosis of rotator cuff tear underwent surgical treatment of rotator cuff repair, but the pain of the operated shoulder persisted due to phase 1 shoulder-hand syndrome. In postoperative week 3, skin temperature measurement using Thermocrons demonstrated a significant decrease in temperature on the operated side (affected side 34.3 ± 0.4°C, healthy side 35.2 ± 0.3°C; P < 0.05).

Conclusion

The changing of the skin temperature during night-time was successfully recorded both in the healthy subjects and a case with shoulder-hand syndrome using a Thermocron.     

Changes with time in skin temperature of the shoulders in healthy controls and a patient with shoulder-hand syndrome

Abstract

Background. Abnormal skin temperature in the shoulder is caused by various diseases. A thermography is unable to capture temperature changes over time. In contrast, a Thermocron is an effective measuring device to monitor temperature changes over time.

Purposes. The purposes of this study employing a Thermocron were to measure shoulder skin temperature over time in healthy subjects and to detect shoulder skin temperature abnormalities in a patient with shoulder-hand syndrome.

Subjects and methods. Subjects comprised 10 healthy volunteers (20 shoulders; 4 men and 6 women, mean age 54 years). For measurements, a Thermocron was attached on both shoulders. Measurements were made from 21.00 to 07.00 the following morning at 15-minute intervals.

Results. Gradual difference in right and left shoulder skin temperature was observed with the timing of measurements but no significant difference was apparent, i.e. dominant side 34.9 ± 0.8°C, non-dominant side 34.9 ± 0.9°C (P = 0.28).

Presentation of a case with shoulder-hand syndrome. A 54-year-old woman with the diagnosis of rotator cuff tear underwent surgical treatment of rotator cuff repair, but the pain of the operated shoulder persisted due to phase 1 shoulder-hand syndrome. In postoperative week 3, skin temperature measurement using Thermocrons demonstrated a significant decrease in temperature on the operated side (affected side 34.3 ± 0.4°C, healthy side 35.2 ± 0.3°C; P < 0.05).

Conclusion. The changing of the skin temperature during night-time was successfully recorded both in the healthy subjects and a case with shoulder-hand syndrome using a Thermocron.     

回顾性研究脑卒中后复杂性区域疼痛综合征与细胞因子的相关性

目的 探索静脉血细胞因子与脑卒中后复杂性区域疼痛综合征(complex regional pain syndrome,CRPS)的相关性,探讨细胞因子检测在辅助脑卒中后CRPS诊断中的应用价值.方法 连续收集2017年1月至2020年12月首次因脑卒中于华山医院北院康复医学科住院患者的临床资料,将脑卒中病程6个月以内的...     

肩袖撕裂患者肩峰下滑囊中VEGF的表达

目的: 观察细胞因子VEGF(血管内皮生长因子)在肩袖撕裂患者肩峰下滑囊(subacromial bursa, SAB)中的表达. 方法: 在肩袖撕裂患者修复手术中,分别取撕裂处和远离撕裂处SAB,对照组取非肩袖撕裂患者正常的SAB,采用免疫组织化学方法观察VEGF在肩峰下滑囊中的表达,通过计算机图像分析系统对SAB切片的VEGF阳性表达进行定量分析. 结果: 实验组所有肩袖撕裂患者SAB中,无论是取自撕裂部位还是远隔部位,均可见细胞数量和血管分布的增加,且均未观察到有大量炎性细胞浸润. 实验组所有肩袖撕裂患者SAB中VEGF阳性表达均显著高于正常,且血管周围表达明显增高,经过统计学分析,肩袖撕裂患者SAB中VEGF较高表达与对照相比差异显著,然而撕裂部位与远隔部位相比无显著差异. 结论: 肩袖撕裂患者SAB中有炎性反应存在,本研究中VEGF在肩袖撕裂患者SAB中的增加与炎性反应密切相关,范围也不单纯局限于撕裂部位. SAB的变化可能系组织炎性反应引起的继发反应,与肩袖撕裂的发生发展有关.     

A study of bone densitometry in patients with complex regional pain syndrome after stroke

INTRODUCTION—This study was undertaken to evaluate the bone mineral density (BMD) in patients with complex regional pain syndrome type-I (CRPS-I) after stroke, and to correlate it with various clinical and neurophysiological parameters.
PATIENTS AND METHODS—Twenty patients with CRPS-I after stroke were included and a detailed neurological evaluation was carried out. The severity of CRPS-I was graded on the basis of shoulder hand syndrome score. All the patients underwent bone mineral densitometry of paralysed and non-paralysed forearm by dual energy x ray absorptiometry. The BMD of paralysed forearm was also compared with that of age matched healthy controls. Neurophysiological tests included sympathetic skin response in both upper and lower limbs and median somatosensory evoked potentials.
RESULTS—The mean age of patients was 57.2 (45-75) years and eight were females. Eight patients had severe weakness and 12 had moderate weakness of grade 2 on the hemiplegic side. There was significant reduction in BMD in the patients compared with controls (p<0.01). The bone density reduction correlated well with duration of illness (r = −0.673, p<0.01), shoulder hand syndrome score (r = −0.804, p<0.01), and Canadian neurological scale score (r = −0.738 p<0.01). Sympathetic skin response was not recordable bilaterally in all patients. Median somatosensory evoked potentials were not recordable in seven out of 20 patients who also had higher grade of CRPS-I.
CONCLUSION—Our results show significant reduction of BMD in patients with CRPS-I after stroke. The reduction in BMD correlates with the severity of shoulder hand syndrome score, degree of weakness, duration of hemiplegia, and the severity of stroke.


     

代谢综合征及泌乳素对慢性精神分裂症患者骨密度的影响

目的 探讨代谢综合征（metabolic syndrome,MS）和高泌乳素血症（hyperprolactinemia,HPRL）对慢性精神分裂症患者骨密度（bone mineral density,BMD）的影响。方法 将杭州市第七人民医院2021年6月至12月收治的156例长期住院的慢性精神分裂症患者按照有无MS和HPRL分为对照组、MS组、HPRL组和MS+HPRL组。记录各组患者的性别、年龄,测量身高、体重,并计算体质量指数（body mass index,BMI）,检测果糖胺（fructosamine,FA）、三酰甘油（triglyceride,TG）、总胆固醇（total cholesterol,TC）、高密度脂蛋白胆固醇（high–density lipoprotein cholesterol,HDL–C）、低密度脂蛋白胆固醇（low–density lipoprotein cholesterol,LDL–C）及泌乳素（prolactin,PRL）水平。超声骨密度仪测定患者跟骨的BMD。分析BMD与各指标间的相关危险因素。结果 对照组BMD大于MS组、HPRL组和MS+HPRL组（P<0.05）,MS组和HPRL组BMD大于MS+HPRL组（P<0.05）。相关分析显示,BMD与BMI呈正相关,与年龄、FA、PRL呈负相关。多因素线性回归分析显示,年龄、BMI、MS、HPRL是影响BMD的独立相关因素。结论 MS和HPRL是导致长期住院的慢性精神分裂症患者BMD下降的重要因素。     

核素骨显像在严重急性呼吸综合征患者恢复期骨坏死诊断中的应用价值

目的评估核素骨显像在严重急性呼吸综合征(SARS)患者恢复期骨坏死诊断中的应用价值。方法对69例康复后4～6个月的SARS患者行股骨头区99Tcm-MDP骨三相及全身骨扫描,并与同期MRI结果进行比较。结果骨三相发现16例患者31个股骨头呈不同阶段、不同程度的典型骨坏死表现,其中97%有MRI异常;23例患者42个股骨头为可疑坏死,其中67%为MRI阴性;30例正常表现患者中3例MRI为可疑。全身骨扫描发现29例患者有其他部位异常,包括15例膝关节骨坏死。结论核素骨显像对检出极早期骨坏死具有优势,其价值与MRI互补。     

继发性甲状旁腺功能亢进的血液透析患者骨代谢及骨密度研究

目的探讨继发性甲状旁腺功能亢进（secondary hyperparathyroidism, SHPT）的维持性血液透析患者骨密度及骨代谢特点。方法156例患者纳入本研究,常规检测透析前血钙、血磷、碱性磷酸酶、C反应蛋白,化学发光法检测血清全段甲状旁腺素（iPTH）、骨钙素（OC）、I型前胶原氨基末端前肽（PINP）、β胶原蛋白水平（β-CTX）,双能X线法测定患者骨密度。结果维持性血液透析患者诊断SHPT 66例,非SHPT 90例。 SHPT患者较非SHPT患者OC[（197.36±177;44.19）ng/ml vs.（527.89±177;85.53）ng/ml,P＆lt;0.001],PINP[（327.15±177;40.40）ng/ml vs.（616.99±177;125.82）ng/ml, P＆lt;0.001]、β-CTX[（1.99±177;0.16）ng/ml vs.（2.47±177;0.15）ng/ml,P=0.049]水平增高。 SHPT患者较非SHPT患者骨密度结果全身平均BMD值[（1.01±177;0.12） vs.（0.93±177;0.14）,P=0.017],Z值[（-0.78±177;0.50） vs.（-1.00±177;0.79）,P=0.043]减低;lo-gistic回归分析,透析前血磷（P=0.000）、OC（P=0.007）、透析龄（P=0.002）是SHPT的独立影响因素。结论全面评估SHPT患者骨代谢指标及骨密度情况,对于患者SHPT骨病的诊断及治疗有着重要意义。     

肿瘤患者的骨痛与骨转移分析

目的　分析骨痛与肿瘤骨转移的关系 ,并探讨骨转移骨痛的可能机理。方法　对 2 5 2例主诉骨痛的肿瘤患者的骨显像结果与其骨痛部位、数目及发生时间进行分析。结果　①有骨痛的各类型肿瘤患者骨转移率平均为64 .7%,其中以前列腺癌为最高 ;骨转移阴性和阳性患者平均骨痛部位数目分别为 1.0 5和 1.73个 ;主诉骨盆骨痛的患者骨转移率最高 ,达到 10 0 %;②骨痛出现的病程时间相对集中在半年至 5年 ,各时间段均可发生转移 ;骨转移病灶数平均为 7.5 7个 ,有随时间段的后移而增加的趋势。结论　①有骨痛主诉时 ,患者骨转移率已高达 64 .7%,而且常为多灶转移 ,已基本失去肿瘤骨转移的早期治疗机会。②对高发骨转移的肿瘤患者应及早进行骨显像检查 ,同时 ,要根据不同类型的肿瘤骨转移特点 ,确定适宜的骨显像随访期 ,这对于肿瘤治疗方案的确定及疗效评估、预后判定均有重要意义     

骨扫描在肺癌和前列腺癌骨转移疗效监测及预后判断中的应用价值

目的探讨全身骨扫描在肺癌和前列腺癌骨转移疗效监测及预后判断中的应用价值。方法将40例肺癌患者和31例前列腺癌患者在系统治疗前1个月内及治疗≥3个月后分别行全身骨扫描,观察治疗前后骨转移灶的变化与肿瘤临床综合疗效的相关性。采用Kaplan-Meier法计算生存率,Log-rank检验及Cox回归模型分析影响肺癌或前列腺癌骨转移预后的危险因素。结果肿瘤临床综合治疗有效者（59.68%,37/62）的骨转移疗效明显好于无效者（40.32%,25/62）（P〈0.05）。肺癌骨转移患者的1年生存率为54.5%,2年生存率为22.6%;前列腺癌骨转移患者的1年生存率为87.3%,2年生存率为72.3%。单因素及Cox多因素分析均显示：肺癌和前列腺癌骨转移患者的生存率与肿瘤类型及骨转移时长相关（P〈0.05）。肺癌与前列腺癌分组行Cox多因素分析结果显示：肺癌骨转移的预后危险因素为病理类型、治疗前骨扫描病变范围及骨转移时长;而前列腺癌骨转移的预后与骨转移时长有关。结论全身骨扫描为肺癌和前列腺癌骨转移的疗效监测及预后判断提供了更丰富、更准确的信息。     

雌孕激素替代治疗对特纳综合征患者骨密度的影响

对8例特纳综合征患者进行6年的雌孕激素补充治疗,比较治疗前后骨密度的变化。治疗前患者的骨密度明显低于同龄同性别的正常水平。经过6年性激素治疗后,患者的骨密度略有增加,但仍显著低于同龄同性别的正常水平。第2～4腰椎的骨密度从（0．75±0．12）g／cm^2增加到（0．84±0．22）g／cm^2,同龄同性别的z评分从-3．2±0．9升高到-2．2±0．6。髋部总体的骨密度从（0．68±0．07）g/cm^2增加到（0．81±0．08）g／cm^2,Z评分从-2．2±0．5增加到-1．2±0．3。长期雌孕激素补充治疗,可改善特纳综合征患者的骨密度,但不能使骨密度恢复到正常水平。     

全凭静脉麻醉复合臂丛神经阻滞对肩袖损伤患者术中血压、术野评分及术后VAS评分的影响

目的探讨全凭静脉麻醉复合臂丛神经阻滞对肩袖损伤患者术中血压、术野评分及术后VAS评分的影响。方法将2015年1月～2017年8月我院收治的86例肩袖损伤患者随机分为试验组与对照组,每组43例,对照组仅予以全凭静脉麻醉,试验组予以全凭静脉麻醉复合臂丛神经阻滞。记录并比较两组患者的MAP与HR、术野评分、术后镇痛药物使用情况、VAS评分。结果对照组拔管后(包括拔管时与拔管后5 min)的MAP与HR明显高于麻醉前(P0.05),试验组拔管后(包括拔管时与拔管后5 min)的MAP与HR与麻醉前比较差异无统计学意义(P0.05);试验组术中20 min、40 min及60 min时的术野评分均低于对照组(P0.05);试验组舒芬太尼用量[(0.38±0.11)μg/kg]显著低于对照组[(0.71±0.23)μg/kg],术后镇痛泵按压次数[(7.7±1.6)次]也明显少于对照组[(12.5±2.1)次],组间差异均有统计学意义(P0.05);术后6 h、12 h、24 h,试验组VAS评分均显著低于对照组,组间差异具有统计学意义(P0.05)。结论全凭静脉麻醉复合臂丛神经阻滞可更好地维持术后血流动力学稳定,增加手术清晰度,有效缓解术后疼痛,减少镇痛药物用量。