| 俞彩琴,沈国昌.改良面神经阻滞术穿刺点选择与穿刺角度深度测量的临床研究[J].浙江中西医结合杂志,2026,36(1): |
| 改良面神经阻滞术穿刺点选择与穿刺角度深度测量的临床研究 |
| Clinical study on selection of optimal puncture point and measurement of puncture angle and depth for improve facial nerve block |
| 投稿时间：2024-08-20 修订日期：2024-12-09 |
| DOI： |
| 中文关键词: 神经传导阻滞 面神经 穿刺 角度 深度 |
| 英文关键词:Nerve block Facial nerve Puncture Angle Depth |
| 基金项目:2021年杭州市卫生科技计划一般 (B类 )项目B20210218 |
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| 中文摘要: |
| 目的:对比传统方法穿刺和乳突前缘入路利用神经定位刺激器引导进行面神经干阻滞治疗的应用效果,进一步提高穿刺操作的成功率,为临床操作提供数值化穿刺依据及方法,具有一定的操作指导意义。方法:选择2021年3月~2023年12月期间我院收治的80例面瘫患者作为研究对象,采用随机数字表法分为两组,各40例。对照组给予传统方法穿刺,实验组患者乳突前缘入路利用神经定位刺激器引导进行面神经干阻滞治疗,对比两组患者穿刺成功率、并发症(穿刺部位感染、血管损伤出血、其他神经损伤等)、穿刺深度,且两组患者使用专业量角器对穿刺角度进行测量,尤其穿刺针与冠状面、水平位的夹角的测量。结果:实验组穿刺成功率为100.00%,对照组为80.00%,实验组穿刺成功率显著高于对照组(P＜0.05)。实验组并发症发生率为2.5%,对照组为20.00%,实验组并发症发生率显著低于对照组(P＜0.05)。两组患者穿刺深度对比无差异(P＞0.05),实验组穿刺针与冠状面的夹角小于对照组,穿刺针与水平位的夹角大于对照组(P＜0.05)。结论:利用神经刺激仪引导神经刺激针定位面神经进行面神经干阻滞治疗,比传统方法穿刺点选择更佳,使定位更精准,显著提高穿刺成功率,同时显著提高有效率,是一种值得借鉴的临床应用方法。 |
| 英文摘要: |
| Objective: to compare the clinical effects of facial nerve trunk block guided by nerve localizing stimulator between the traditional puncture method and the anterior approach of mastoid process. Methods: Eighty patients with facial paralysis were selected from March 2021 to December 2023. They were randomly divided into two groups with 40 cases in each group. The patients in the control group were punctured by the traditional method, while the patients in the experimental group were treated by facial nerve trunk block guided by the neuro-localizing stimulator through the anterior approach of mastoid process, the puncture success rate, complications (infection at puncture site, blood vessel injury and bleeding, other nerve injury, etc.) and puncture depth were compared between the two groups, especially, the angle between the needle and the coronal plane or horizontal position was measured. Results: the puncture success rate of the experimental group was 100.00% , and that of the control group was 80.00% . The puncture success rate of the experimental group was significantly higher than that of the control group (P＜0.05) . The incidence of complications was 2.5% in the experimental group and 20.00% in the control group. The incidence of complications in the experimental group was significantly lower than that in the control group (P＜0.05) . There was no significant difference between the two groups (P＜0.05) . The angle between the puncture needle and the coronal plane in the experimental group was smaller than that in the control group, and the angle between the puncture needle and the horizontal position was larger than that in the control group (P＞0.05) . Conclusion: using nerve stimulator to guide nerve stimulator to locate the facial nerve for the treatment of facial nerve trunk block is better than the traditional method in selecting the puncture point, making the location more accurate and raising the puncture success rate significantly, at the same time significantly improve the effective rate, is a worthy reference to the clinical application of methods. |
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