超声引导下股神经阻滞在膝关节置换术患者中的应用价值分析

目的探讨超声引导下股神经阻滞在膝关节置换术患者中的应用价值。方法选取2018年3月至2019年9月在我院行膝关节置换术的92例患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各46例。对照组患者给予常规镇痛药物治疗,观察组患者给予超声引导下肢神经阻滞镇痛治疗。比较两者患者镇静满意度、静息8、12、24及48h的疼痛视觉模拟评分(VAS)和不良反应发生情况。结果观察组患者镇静满意度明显高于对照组,静息8、12、24及48h的VAS评分均明显低于对照组,不良反应发生率明显低于对照组,差异具有统计学意义(P0.05)。结论超声引导下股神经阻滞应用于膝关节置换术中,能提高患者镇静满意度,改善患者疼痛程度,减少不良反应的发生。     

超声引导下竖脊肌阻滞在同种异体肾移植术中的应用

目的:探讨超声引导下竖脊肌平面(erector spinae plane,ESP)阻滞在同种异体肾移植术中的应用效果.方法:择期选取同种异体肾移植患者60例,ASAⅢ级,随机均分为ESP阻滞组(E组)与对照组(C组).E组患者于全麻诱导后行超声引导下ESP阻滞,C组不进行此项操作.2组患者术后均采用静脉自控镇痛泵镇痛....     

超声引导下股神经阻滞应用于膝关节镜术后镇痛的临床观察

目的　评价超声引导下股神经阻滞应用于膝关节镜的术后镇痛作用。 方法　60例择期膝关节镜手术患者,随机分为对照组（A组）和试验组（B组）,每组30例。两组患者均在椎管内麻醉下完成手术,B组术毕在超声引导下行股神经阻滞,A组不予任何处理。记录术后6、12、24 h患者静息与活动时VAS疼痛评分及24h内镇痛药补充给予人次、不良反应发生率、患者满意度评分。 结果　A组患者术后6、12、24 h VAS评分及24 h内镇痛药补充给予人次明显大于B组（P＜0.05）;其不良反应发生率高于B组但无统计学意义;A组患者满意度评分明显低于B组（P＜0.05）。 结论　超声引导下股神经阻滞应用于膝关节镜手术,术后镇痛效果确切,不良反应少,患者舒适满意,是一种安全有效的镇痛方式。     

超声引导技术在肌间沟臂丛神经阻滞麻醉中的应用

目的探讨超声引导技术在臂丛神经阻滞麻醉中的临床应用。方法将2012年3月~2012年8月,60例行择期上肢手术的患者,随机分成A、B两组各30例。A组选择在超声引导下行肌间沟臂丛神经阻滞,B组选择传统异感定位肌间沟臂丛阻滞法。所用局麻药为0.45%罗哌卡因40ml。观察并比较两组患者的麻醉起效时间、阻滞完善率、麻醉效果、并发症及术中舒适度。结果 A组仅有2例刺破血管,B组有8例刺破血管、1例局麻药中毒、2例术后感觉异常。结论超声引导下肌间沟臂丛神经阻滞麻醉具有操作时间短、阻滞效果完善、并发症发生率少等特点,有临床推广应用的价值。     

超声引导下胸椎旁阻滞技术的应用进展

近年来,随着超声技术的推广和普及,超声引导下胸椎旁阻滞由于操作简便、成功率高、对呼吸循环影响小、术后并发症少等优点,在临床治疗和麻醉中得以广泛应用.胸椎旁阻滞技术在各种类型的手术中具有多种作用,具有广泛的临床应用前景.     

糖尿病足手术中行超声联合神经刺激仪引导下前入路坐骨神经及股神经阻滞的临床应用价值

目的 探讨糖尿病足（DF）手术中行超声联合神经刺激仪引导下前入路坐骨神经及股神经阻滞的临床应用价值。方法 选择2016年6月至2019年4月于东部战区空军医院行DF手术的糖尿病（DM）患者100例,其中男性58例,女性42例;年龄55～85岁,平均年龄56.78岁。依据随机数字表法将患者分为坐骨神经及股神经阻滞组（观察组）和单次蛛网膜下腔阻滞组（对照组）,每组50例。记录2组患者麻醉前（Tb）、麻醉后5 min(T5)、麻醉后10 min(T10)、麻醉后15 min(T15)、麻醉后30 min(T30)的收缩压（SBP）、舒张压（DBP）和心率（HR）;记录麻醉操作时间（OT）、手术等待时间（SWT）、首次镇痛时间（FAT）、首次自主排尿时间（FUT）;记录2组患者术后6、12、18、24 h时视觉模拟量表（VAS）评分;记录术后麻醉并发症及不良反应发生情况。结果 在T5、T10、T15、T30时,对照组SBP均明显低于观察组[（138.85±17.16） mmHg vs (147.66±13.52) mmHg、（132.96±15.93） mmHg vs (145.29±18.1...     

高频超声检测、引导抽吸注射式隆乳填充物

目的探讨高频超声检测、引导抽吸注射式隆乳术填充物的应用价值。方法应用高频超声检测、确定注射式隆乳术填充物位置，引导穿刺抽吸方向，动态监测抽吸状况。结果25例中14例注射隆乳填充物位置异常，16只乳房皮下层、6只乳房腺体层、4例胸肌层出现填充物，呈无回声区，大小不同，散在或成堆分布；6例（12只乳房）在超声引导下抽吸填充物。结论高频超声能清晰显示注射式隆乳术乳腺后间隙填充物回声，确定填充物异常位置，引导抽吸术的实施。     

高频超声引导下硬膜外分娩镇痛的研究

目的评估高频超声引导下硬膜外穿刺分娩镇痛的可行性。方法选择80例拟行硬膜外穿刺的患者,为分娩的初产妇,妊娠足月,年龄20~35岁。随机分为对照组和观察组,每组各40例。对照组采用常规方法进行定位穿刺,观察组采用超声引导穿刺硬膜外麻醉。穿刺成功后,观察两组穿刺麻醉后镇痛效果、麻醉药物使用量等指标,并进行比较。结果 80例硬膜外穿刺患者均穿刺成功。观察组较对照组减少麻醉药用量;观察组麻醉有效率为97.5%,对照组为92.5%;观察组优于对照组,差异有统计学意义(P0.05)。结论经高频超声引导下硬膜外麻醉穿刺成功率高,减少麻醉药用量,安全性好,是有一定的临床应用价值的方法。     

超声引导下腰方肌阻滞联合丙泊酚麻醉在腹腔镜结直肠癌根治术中的应用

目的:研究超声引导下腰方肌阻滞联合丙泊酚麻醉在腹腔镜结直肠癌根治术中的应用价值。方法:选取90例择期进行腹腔镜结直肠癌根治术患者作为研究对象,随机分为观察组和对照组,各45例。对照组采用传统腰麻联合丙泊酚麻醉,观察组采用超声引导下腰方肌阻滞联合丙泊酚麻醉,比较两组患者术中（麻醉后5、15、30、60 min）收缩压（SBP）、舒张压（DBP）、心率（HR）和术后不同时间段的疼痛评分（VAS评分）,以及加用镇痛药情况和肠道恢复排气时间和术后48 h内不良反应发生情况。结果:两组患者SBP、DBP、HR组间、不同时间点及交互差异均有统计学意义（P<0.05）,且观察组麻醉后上述指标波动较对照组小（P<0.05）;麻醉前,两组患者皮质醇、肾上腺素水平无显著差异（P>0.05）,麻醉后各时间点观察组患者上述指标水平均显著低于对照组（P<0.05）;两组患者VAS评分组间、不同时间点及交互差异均有统计学意义（P<0.05）,且观察组术后各时间点VAS评分均显著低于对照组（P<0.05）;观察组不良反应发生率显著低于对照组（8.89% vs 24.44%, P<0.05）;观察组患者加用镇痛药的人数、剂量和肠道恢复排气时间均显著少于对照组（P<0.05）。结论:超声引导下腰方肌阻滞联合丙泊酚麻醉在腹腔镜结直肠癌手术中具有良好、稳定的麻醉效果,可有效缓解患者疼痛,减少术后不良反应发生。     

超声引导下前锯肌神经阻滞复合腹直肌鞘神经阻滞在肝癌手术中的应用价值

目的:分析超声引导下前锯肌神经阻滞复合腹直肌鞘神经阻滞在肝癌手术中的应用价值.方法:选取本院2019年8月至2021年5月收治的102例进行择期肝癌开腹手术患者作为研究对象.根据不同治疗方法分为对照组(n=49)与研究组(n=53).对照组采用静吸复合全身麻醉,研究组在对照组的基础上采用超声引导下前锯肌神经阻滞复合腹直...     

The effect of patellar taping on patellar position measured using ultrasound scanning

Previous research into the effect of patellar taping has found conflicting results and when studies have found positive findings these effects appear to be negated by exercise. The purpose of this study was to re-examine the effect of patellar taping on patellar position using ultrasound scanning. Twelve asymptomatic subjects (six males and six females (age 20.4 +/? 1.2 years)) had their patellar position examined, prior to and following the application of tape, and also following exercise (25 step ups). Mean patellar position (distance border patella to edge lateral femoral condyle) prior to application of tape was 6.2 +/? 1.3 mm following the application of tape mean patellar position was 7.9 +/? 1.7 mm, this was a statistically significant change in position (p = 0.003). Following exercise mean patellar position was 7.6 +/? 1.7 mm this was a significant reduction compared to the taped position prior to exercise (p = 0.001). This value was though still significantly greater than prior to the application of tape (p = 0.006). This study found that patellar position was significantly changed following the application of tape. Furthermore, the study found that though low intensity exercise resulted in a significant change in the patellar position compared to the taped position prior to exercise, that change was most likely to have occurred due to random chance or measurement error.     

超声引导下髂筋膜间隙神经阻滞在膝关节术后镇痛效果的对照研究

目的　评价超声引导下髂筋膜间隙神经阻滞在膝关节手术的术后镇痛效果。 方法　60例择期膝关节置换手术患者,随机分为对照组（A组）和试验组（B组）,每组30例。两组患者均在全麻下完成手术,B组术前在超声引导下行髂筋膜间隙神经阻滞,A组不予任何处理。记录术后6、12、24 h患者静息与活动时VAS疼痛评分及24 h内镇痛药补充给予人次、不良反应发生率、患者满意度评分。 结果　A组患者术后6、12、24 h VAS评分及24 h内镇痛药补充给予人次明显大于B组（P＜0.05）;其不良反应发生率高于B组但无统计学意义;A组患者满意度评分明显低于B组（P＜0.05）。 结论　超声引导下髂筋膜间隙神经阻滞应用于膝关节手术,术后镇痛效果确切,不良反应少,患者舒适满意,是一种安全有效的镇痛方式。     

The effect of hip adduction angle on patellar position measured using real time ultrasound scanning

IntroductionThere are limited in vivo studies investigating the influence of the Iliotibial Band (ITB) on patellar position, despite numerous references in the literature to this relationship. The purpose of this study was to investigate how the ITB influences patellar position, in vivo, indirectly through alteration of frontal plane hip position.MethodTwelve healthy, asymptomatic, male subjects (age 23 ± 2.6 years) had their patellar position examined using real time ultrasound scanning. The knee was passively placed into 20° flexion and combined with hip neutral, 20° hip adduction and 20° hip abduction. Mean patellar position (distance from the lateral border of the patella to the edge of the intersection of the trochlear groove and lateral femoral condyle) was measured, with the smaller values representing a position whereby the patella is drawn more laterally and closer to the lateral femoral condyle.ResultsMean patellar position for neutral was 8.1 mm (± 1.72 mm). Following 20° hip abduction the mean patellar position was 8.9 mm (± 1.79 mm), this was a statistically significant change in patellar position (p = 0.003). Following 20° hip adduction the mean patellar displacement was 7.3 mm (± 1.4 mm) which, again, was a statistically significant change in patellar position (p = 0.009). The results indicate that with the hip adduction the patella was positioned significantly more laterally (smaller value for distance).DiscussionThe results of this study support the hypothesis that hip adduction which is likely to create loading and lengthening of the ITB causes significantly greater lateral displacement of the patella, than when the hip is abducted and the ITB unloaded.Level of evidence: 2b individual cohort study.     

Topographic anatomy of the tibial nerve in the medial malleolus: application to the effect of nerve block anesthesia

To better understand the anatomical variations and pathogeny of tarsal tunnel syndrome, the tibial nerve were dissected in 20 ankles of fresh black African cadavers. The tibial nerve located to 1.75 cm on average from the posterior side of the malleolus and to 2 cm from medial side of the calcaneus tendon. The nerve always ended according to dichotomic method. 90% cases of bifurcation were noted under the flexor retinaculum at 1 cm from the malléolo_calcaneus line; in 10% of dissections, we found proximal bifurcation at 5 cm from this line. The medal calcaneus branch which is a collateral branch of tibial nerve was constant, unique in 80% of cases and double in 20% of cases. The anatomical constatations allow a more precise anesthesia of tibial nerve block. We use constant anatomical marks formed by calcaneus tendon and internal malleolus tip. Olso we more understand the possibility of lesion of tibial nerve at the ankle during the synovites, or ossifications of flexor rétinaculum.     

高频超声成像中的编码激励研究

本论文实现了基于编码激励的高频超声成像实验系统并对编码激励在实际应用中的性质进行了定量实验研究.以中心频率为10 MHz的眼科B超为实验平台,实现了一个适用于各种二进制编码激励的超声成像系统.系统使用FPGA实现了编码激励实时成像处理,并通过数据采集卡获得射频回波数据.实验表明,采用编码激励可以显著增加系统信噪比,降低发射电压.在单反射面情况下,15 V发射电压的编码激励回波的信噪比与70 V发射电压的单脉冲激励回波的信噪比相当,脉冲压缩的旁瓣水平在-30 dB以下.在超声体模实验中,20 V发射电压的编码激励回波的信噪比水平及穿透深度与60 V发射电压的单脉冲激励系统相当.编码激励实验结果为实现低发射电压的便携式超声诊断系统提供了实验基础.     

Visually guided reaching in the cat reared in fixed or random frequency stroboscopic light

The effect of deprivation of visual perception of movement in a visuo-motor task has been tested in cats reared in stroboscopic light since birth. Three cats were reared in light of fixed (2 flash/sec, flash duration 2 msec) and three in light of random (between 0.5 and 3.5 flash/sec) frequency. These 6 animals, together with 6 control cats, underwent (as adults) a test of visual control of reaching for a target with a paw, with operant conditioning. While the cats raised in fixed frequency stroboscopic conditions (FFS) showed no deficit, those raised in random frequency condition (RFS) exhibited significantly less precise guidance than FFS and control animals.     

彩超引导下经皮脐静脉穿刺术的并发症分析

目的总结超声引导下经皮脐静脉穿刺术并发症的种类及防治方法.方法对52例因各种原因行产前诊断孕妇进行脐静脉穿刺术.结果52例均穿刺成功,发生一过性并发症21例,未出现严重并发症.结论只要严格遵守手术操作原则,经腹脐静脉穿刺术是一种安全、成功率高的产前诊断方法.     

全麻复合硬膜外阻滞在开胸手术的应用效果分析

目的观察全麻复合硬膜外阻滞麻醉用于开胸手术的临床效果。方法选择68例ASA I~Ⅱ择期开胸手术病人随机分为全麻复合连续硬膜外麻醉34例（A组）和单纯全麻34例（B组）,观察麻醉前（T1）、插管时（T2）、切皮时（T3）、拔管时（T4）、拔管后15 m in（T5）各时段两组病人血流动力学变化。结果平均动脉压（MAP）及心率（HR）A、B组间比较,T1、T5时段无显著性差异（P〉0.05）,T2~T4时段有显著性差异（P〈0.01）。结论全麻复合硬膜外阻滞用于开胸手术应激反应小,全麻药量少,病人清醒快,拔管早,术后镇痛完善。     

Comparative anatomical study of the kidney position in amniotes using the origin of the renal artery as a landmark

The anatomical relationship between the kidney position and its arterial supply was investigated in 21 mammals, 1 bird, and 3 reptiles (n = 1 for each species) and in 43 human cadavers. The following observations were made. (1) Although the right kidney was located caudal to the left kidney in 29 out of 43 human cadavers (67.4%), the origin of the right renal artery from the aorta was located cranial to the origin of the left renal artery in 36 human cadavers (83.7%). Therefore, the relative positions of the kidneys do not correspond with the relative origins of the renal arteries in humans. (2) Among the mammals that were examined, the position of the kidney and the branching level of the renal artery on the right side were usually cranial to those on the left side. (3) In the bird and most reptiles that were examined, kidneys were typically located in the pelvic region and were supplied by segmental arterial branches. These results suggest that the right kidney and its arterial supply are generally located cranial to the left kidney in phylogeny of mammals. While the presence of a human accessory renal artery in 9 out of 86 sides (10.5%) and a cranial origin of the left renal artery relative to the right renal artery in 7 out of 43 cadavers (16.3%), shows some variation in the arterial supply to the kidneys, the origin of the renal arteries can generally be used as phylogenetic landmarks indicating the relative positions of the kidneys. Hence, from an ontological perspective, the human right kidney may be initially situated cranial to the left kidney during the early stages of development. Thereafter, the human right kidney may shift downwards secondary.