实用医学杂志2025，Vol.41Issue(9)：1293-1298,6.DOI:10.3969/j.issn.1006-5725.2025.09.004
超声引导下肌间沟与腋路臂丛神经阻滞对终末期肾病患者动静脉内瘘成形术通畅率的影响
Impact of ultrasound guided interscalene versus axillary brachial plexus block on patency rate of arteriove-nous fistula
摘要
Abstract
Objective To compare the safety and efficacy of various brachial plexus block techniques using local anesthesia(LA)in patients undergoing their first radiocephalic arteriovenous fistula(RCAVF)surgery.Methods Patients were randomly allocated into three groups:LA,interscalene brachial plexus block(ISBPB),and axillary brachial plexus block(ABPB).Ultrasound was utilized to evaluate the pre-and post-anesthesia changes in vessel diameter and blood flow.Postoperative follow-up assessments were performed at three days and three months to determine fistula patency.Results Immediate patency rates were 92.52％(LA),96.26％(ISBPB),and 95.33％(ABPB),with no statistically significant differences among the groups(χ²=1.615,P=0.446).However,at three months,primary patency rates differed significantly among the groups(χ²=22.691,P<0.001).Specifically,the ISBPB group(83.18％)exhibited significantly higher patency compared to the LA group(57.01％)(χ²=17.477,P<0.001).Similarly,the ABPB group(80.37％)demonstrated better patency than the LA group(χ²=13.580,P<0.001).Regarding respiratory complications,they were more prevalent in the ISBPB group(15.89％)compared to the LA group(2.80％)(χ²=9.761,P=0.002)and the ABPB group(0.93％)(χ²=14.377,P<0.001).No significant difference was observed between the LA and ABPB groups in terms of respiratory complications(χ²=1.019,P=0.313).Conclusions Both ISBPB and ABPB demonstrated superior primary patency compared to LA.Nevertheless,ABPB exerted a lesser impact on respiratory function and provided a more comfortable surgical experience for ESRD patients.关键词
动静脉内瘘/终末期肾病/肌间沟入路臂丛神经阻滞/腋路臂丛神经阻滞Key words
autogenous arteriovenous fistula/end-stage renal disease/interscalene brachial plexus block/axillary brachial plexus block分类
临床医学引用本文复制引用
张弛,李筱,魏祥,陈刚毅,李红梅,王可佳,郑俊奕..超声引导下肌间沟与腋路臂丛神经阻滞对终末期肾病患者动静脉内瘘成形术通畅率的影响[J].实用医学杂志,2025,41(9):1293-1298,6.基金项目
广东省哲学社会科学规划项目(编号:GD22CGL36) （编号:GD22CGL36）
