Daim Ntawv Thov Ntawm Echogenic Needles Hauv Siab -BMI Tus Neeg Mob Nerve Block Tshuaj loog

https://www.nature.com/articles/s41598-024-72620-8

1. Cov Ntsiab Lus Kho Mob

Siab -BMI cov neeg mob rog rog yeej ib txwm yog ib pab pawg nyuaj rau peripheral hlab ntsha thaiv tshuaj loog. Ib tug loj npaum li cas ntawm subcutaneous adipose cov ntaub so ntswg tsub kom qhov tob ntawm lub paj hlwb, thiab cov nqaijrog muaj zog ultrasonic attenuation, uas ua rau pom qhov muag plooj ultrasound ntawm lub hom phiaj paj hlwb thiab nyuaj qhia txog cov tswv yim koob. Cov koob txhaj tshuaj zoo ib yam muaj cov cim tsis muaj zog hauv siab - cov ntaub so ntswg rog, ua kom pom kev hnyav, tsis tuaj yeem taug qab qhov tob tob hauv lub sijhawm. Cov kws kho mob tsuas tuaj yeem vam khom qhov muag tsis pom kev, nrog rau qhov tsis tshua muaj qhov tseeb qhov tseeb, qhov thaiv tsis tiav siab thiab tsis tshua muaj kev mob tshwm sim. Tsis tas li ntawd, cov neeg mob rog rog muaj kev sib tshooj ntawm cov hlab ntsha sib sib zog nqus thiab cov hlab ntsha, qhov muag tsis pom kev yog ib qho yooj yim ua rau cov hlab ntsha raug mob, hematoma thiab cov hlab ntsha puas tsuaj. Kev siv tshuaj loog hauv zos ntau dhau los ntawm qhov chaw tsis raug kuj ua rau muaj kev pheej hmoo ntawm cov tshuaj lom hauv cov neeg mob rog, ua rau muaj kev nyab xeeb zoo rau kev kho tshuaj loog.

2. Txoj Cai Ua Haujlwm ntawm Echogenic Nerve Block koob

Echogenic paj hlwb thaiv koob daws cov teeb meem tshuaj loog ntawm siab -BMI cov neeg mob los ntawm kev txhim kho ncha tshuab thiab tiv thaiv - cuam tshuam ob qhov chaw. Lub optimized laser sib sib zog nqus ncha marking thiab multi- txheej txheem electropolishing zoo heev txhim kho lub ultrasonic reflection siv ntawm lub cev koob, zoo tiv thaiv lub ultrasonic attenuation cuam tshuam ntawm tuab adipose ntaub so ntswg, thiab muaj peev xwm nthuav tawm meej thiab ruaj khov siab -brightness imaging nyob rau hauv sib sib zog nqus siab - rog cov ntaub so ntswg, realizing puncture realtime{6} Lub siab -sensitivity hluav taws xob paj hlwb stimulation system muaj zog tiv thaiv- rog cuam tshuam muaj peev xwm, uas tuaj yeem raug ntes cov cim bioelectrical ntawm cov hlab ntsha sib sib zog nqus, ua rau cov leeg nqaij khov kho cov lus tawm tswv yim, thiab txheeb xyuas cov koob taub txoj hauj lwm ywj pheej ntawm ultrasound imaging zoo. Qhov sib ntxiv dual -mode positioning thev naus laus zis ntawm lub zeem muag thiab cov teeb liab hluav taws xob ua tiav daws cov teeb meem ntawm cov duab nyuaj thiab qhov chaw tsis raug ntawm cov hlab ntsha hauv siab -BMI cov neeg mob, paub meej cov hlab ntsha sib sib zog nqus.

3. Kev faib cov cuab yeej thiab kev hloov kho cov xwm txheej

For high-BMI patient anesthesia scenarios, echogenic needles are divided into deep enhanced echo type (16G-18G) and long anti-attenuation type (19G-20G). The 16G-18G deep enhanced echo needles are suitable for patients with BMI>30, siv rau ultra- cov hlab ntsha sib sib zog nqus xws li lub duav, lub plab hauv plab thiab qhov qis qis qis qis, nrog lub zog muaj zog echo los tiv thaiv- muaj peev xwm attenuation, ruaj khov duab hauv cov roj tuab tuab. Lub 19G-20G ntev los tiv thaiv-attenuation echogenic koob yog tsim rau cov neeg mob uas muaj BMI 25-30, yoog raws li niaj hnub kev sib sib zog nqus hlab ntsha ntawm sab sauv thiab qis qis, nrog kev sib npaug sib npaug thiab ncha nkag mus. Tag nrho cov khoom siv lub cev ntev ntev tsim thiab cov khoom siv hlau tsis muaj zog, uas tuaj yeem ua tau raws li qhov xav tau ntawm cov neeg mob siab BMI tsis muaj rab koob lub cev khoov thiab deformation.

4. Cov Txheej Txheem Kev Ua Haujlwm

Preoperatively ntsuam xyuas tus neeg mob tus BMI Performance index, rog tuab thiab lub hom phiaj paj hlwb qhov tob, xaiv enhanced anti-attenuation echogenic koob specifications. Txais yuav tsawg- zaus sib sib zog nqus cov ntaub so ntswg ultrasound sojntsuam, tsim nyog kho ultrasound nce thiab qhov tob tsis zoo los txhim kho cov hlab ntsha sib sib zog nqus pom meej. Kos cov kev taw qhia dav dav ntawm cov hlab ntsha sib sib zog nqus thiab ib puag ncig cov qauv vascular tseem ceeb. Txais yuav ruaj khov nyob rau hauv - dav hlau sib sib zog nqus puncture txheej txheem, ua ntej lub lengthened echogenic koob maj mam thiab uniformly, thiab saib xyuas cov koob nkag trajectory nyob rau hauv lub sij hawm los ntawm kev txhim kho cov duab ultrasound. Tig rau lub siab -rhiab heev paj hlwb stimulation hom, zoo- kho lub koob txoj hauj lwm raws li cov leeg nqaij contraction tawm tswv yim kom txog rau thaum lub zoo paj hlwb nyob ze lub xeev tiav. Txhaj tshuaj loog hauv zos hauv cov khoom siv thiab ua kom muaj nuj nqis raws li lub sijhawm saib xyuas tiag tiag, saib xyuas cov tshuaj diffusion hauv cov ntaub so ntswg sib sib zog nqus, paub meej tias cov hlab ntsha raug muab qhwv, thiab ua tiav cov haujlwm thaiv.

5. Kev Paub Txog Kev Kho Mob

Cov ntaub ntawv kho mob qhia tau tias cov koob tshuaj echogenic txhim kho tau thim rov qab cov tshuaj loog ntawm qhov siab -BMI cov neeg mob. Rau cov neeg mob rog rog nrog BMI ntau dua 30, cov hlab ntsha sib sib zog nqus qhov kev vam meej ntawm cov koob zoo tib yam tsuas yog 62%, thaum siv cov koob tshuaj echogenic txhim kho nce qhov kev vam meej mus rau 95%. Kev tiv thaiv - attenuation echo qauv zoo daws qhov teeb meem ntawm qhov pom tsis pom koob hauv cov roj txheej, txo qhov kev hloov kho lub sij hawm los ntawm ntau dua 70%, thiab ua kom lub sij hawm siv tshuaj loog txo qis ib nrab. Kev tiv thaiv dual -kev cuam tshuam qhov chaw siv thev naus laus zis zam kev raug mob vascular thiab paj hlwb los ntawm qhov muag tsis pom kev, thiab qhov tshwm sim ntawm kev ua haujlwm tsis tiav thiab cov teeb meem tom qab phais raug txo los ntawm 68%. Qhov tseeb ntawm qhov txo qis qhov muag tsis pom qhov nce ntawm cov tshuaj loog, txo qhov kev pheej hmoo ntawm kev siv tshuaj loog hauv cov neeg mob rog rog, thiab ua rau cov tshuaj loog hauv lub xeev ruaj khov thiab nyab xeeb dua.

6. Cov ntsiab lus thiab sublimation

Siab -BMI cov neeg mob rog rog yeej ib txwm yog pab pawg tseem ceeb thiab nyuaj ntawm cov tshuaj loog hauv cheeb tsam vim muaj kev cuam tshuam ntawm cov ntaub so ntswg adipose ntawm ultrasound imaging thiab paj hlwb positioning. Cov cuab yeej tsoos tsoos thiab ib qho kev qhia txog kev siv tshuab ultrasound yog qhov nyuaj rau kev hloov mus rau qhov sib sib zog nqus cov ntaub so ntswg xav tau ntawm cov neeg mob rog, nrog qhov tseeb tsawg thiab muaj kev nyab xeeb siab. Echogenic paj hlwb thaiv koob cia siab rau txhim kho ncha los tiv thaiv- thev naus laus zis thev naus laus zis thiab dual- hom tiv thaiv - cuam tshuam qhov chaw los cuam tshuam los ntawm kev cuam tshuam ntawm cov neeg mob rog tshuaj loog. Nws txhim kho qhov ua tau zoo thiab kev nyab xeeb ntawm cov hlab ntsha hauv siab -BMI cov neeg mob, ua rau cov kev sib txawv ntawm kev siv tshuaj loog nyuaj rau cov pab pawg tshwj xeeb, thiab txhim kho cov kev pab them nqi thiab qhov tseeb ntawm kev kho mob hauv cheeb tsam tshuaj loog.

7. Cov kev cia siab rau yav tom ntej thiab cov lus qhia

Nrog rau kev nce ntxiv ntawm kev rog rog, tus naj npawb ntawm -BMI cov neeg mob phais mob tseem nce ntxiv, thiab qhov kev thov rau kev siv tshuaj loog nyuaj yog nce. Nws raug nquahu kom siv tshuaj loog ntawm cov pab pawg neeg rog tshwj xeeb raws li cov lus qhia tseem ceeb ntawm cov koob tshuaj echogenic, thiab ua kom muaj txiaj ntsig zoo los tiv thaiv - cov khoom lag luam attenuation hauv cov tsev kho mob loj tertiary. Tsim cov tshuaj loog tshwj xeeb kev ua haujlwm tshwj xeeb rau siab -BMI cov neeg mob, ntxiv dag zog rau cov kws kho mob cov kev ua haujlwm tau zoo hauv qhov tob tob thiab tiv thaiv- cuam tshuam qhov chaw. Txhim kho cov khoom sib sib zog nqus ncha txhim kho thev naus laus zis, txhim kho ultra- sib sib zog nqus los tiv thaiv- cov koob tshwj xeeb rau cov neeg mob rog rog, ntxiv txhim kho qhov tseeb ntawm qhov tseeb ntawm ultra- cov hlab ntsha sib sib zog nqus, thiab lav tag nrho cov tshuaj loog kev nyab xeeb ntawm pab pawg tshwj xeeb.