Daim ntawv thov ntawm Echogenic koob nyob rau hauv qis Extremity Deep Nerve Block Surgery

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

1. Cov Ntsiab Lus Kho Mob

Cov kev phais hauv qis qis xws li pob txha pob txha, lub hauv caug arthroscopy thiab kho calf trauma yuav tsum tau siv cov hlab ntsha sib sib zog nqus thaiv cov tshuaj loog nrog rau cov hlab ntsha sciatic thiab femoral paj hlwb, uas ib txwm yog ib qho nyuaj rau kev tshuaj loog hauv cheeb tsam. Lub hom phiaj ntawm cov hlab ntsha ntawm qis qis yog qhov tob hauv lub cev, npog los ntawm cov ntaub so ntswg adipose tuab thiab cov leeg nqaij, ua rau tsis zoo ntawm ultrasound imaging txhais. Ordinary puncturekoobs muaj lub suab tsis muaj zog hauv cov ntaub so ntswg sib sib zog nqus, ua rau nws nyuaj rau cov kws kho mob kom paub meej txog lub koob trajectory thiab nrhiav qhov tseeb ntawm lub paj hlwb. Kev coj noj coj ua ntawm ib qho ultrasound ib txwm ua rau qhov muag tsis pom kev, ua rau qhov tob tob tob, raug mob rau cov hlab ntsha sib sib zog nqus thiab cov ntaub so ntswg pleural, lossis kev sib txawv ntawm rab koob ntau dhau ua rau ua tsis tiav. Tsis tas li ntawd, rau cov neeg mob rog rog nrog cov rog rog subcutaneous, qhov nyuaj ntawm cov hlab ntsha sib sib zog nqus nce ntxiv, nrog rau qhov tshwm sim ntawm cov tshuaj loog ua tsis tiav, kev mob tshwm sim hauv lub cev thiab kev ua haujlwm tsis zoo tom qab phais mob, cuam tshuam rau kev nyab xeeb ntawm kev phais thiab tus neeg mob.

2. Txoj Cai Ua Haujlwm ntawm Echogenic Nerve Block Needles

Echogenic paj ntaub thaiv cov koob daws qhov teeb meem ntawm kev sib sib zog nqus cov ntaub so ntswg puncture positioning los ntawm optimized lub cev qauv thiab dual ntse positioning technology. Lub laser precision marking thiab tshwj xeeb electropolishing txheej txheem nyob rau hauv lub koob nto txhim kho lub ultrasonic reflection coefficient, ua rau lub cev koob thiab lub taub hau kom meej meej siab - ncha dluab txawm nyob rau hauv tob qis - pom cov ntaub so ntswg, realizing tag nrho - txheej txheem tiag - lub sij hawm trajectory xyuas. Qhov sib txuam hluav taws xob paj hlwb stimulation system outputs adjustable low - zaus tam sim no. Thaum lub koob taub hau mus txog lub hom phiaj sib sib zog nqus xws li paj hlwb sciatic thiab cov hlab ntsha femoral, nws ua rau cov leeg nqaij qis qis qis. Cov kws kho mob tuaj yeem txiav txim siab qhov kev ncua deb thiab qhov chaw txheeb ze ntawm lub koob taub thiab cov hlab ntsha los ntawm lub zog thiab ntau yam ntawm cov leeg nqaij stimulation, paub meej qhov chaw tsis muaj kev txiav txim siab. Kev sib xyaw ua ke ntawm kev pom kev pom ultrasound thiab cov tswv yim hluav taws xob cov paj hlwb tau ua tiav cov txiaj ntsig zoo, ua tiav qhov kev cuam tshuam ntawm qhov sib sib zog nqus adipose thiab cov leeg nqaij.

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

Rau qhov qis qis ntawm cov hlab ntsha sib sib zog nqus thaiv cov xwm txheej, cov koob echogenic feem ntau muab faib ua cov qauv ntev -cov qauv sib sib zog nqus (8G-20G) thiab txhim kho ncha tuab- lub cev qauv. 18G-20G cov pa sib sib zog nqus echogenic koob yog tsim rau niaj hnub femoral paj hlwb, obturator paj hlwb thiab lateral femoral cutaneous paj hlwb hauv lub hauv caug thiab calf phais, nrog rau cov koob lub cev hardness thiab echo kev ua tau zoo. 8G-17G thickened enhanced echogenic koob yog tsim los rau cov neeg mob rog rog thiab lub duav sib sib zog nqus sciatic paj ntaub thaiv, nrog rau lub cev tuab thiab muaj zog tiv thaiv kev cuam tshuam, uas muaj peev xwm tswj kom meej meej pom nyob rau hauv tuab adipose ntaub so ntswg. Tag nrho cov khoom siv lub zog siab kho mob stainless hlau, nrog rau kev ua haujlwm siab kom tsis muaj menyuam thiab kho tau ntev ntev, yoog rau cov neeg mob lub cev sib txawv thiab qhov sib txawv ntawm qhov tob qis qis ntawm cov hlab ntsha thaiv kev ua haujlwm.

4. Cov Txheej Txheem Kev Ua Haujlwm

Preoperatively ntsuam xyuas tus neeg mob lub BMI, qhov chaw phais thiab lub paj hlwb qhov tob, xaiv qhov matched echogenic koob specification, thiab debug lub ultrasound ntsuas nrog tsawg- zaus convex sojntsuam haum rau cov ntaub so ntswg sib sib zog nqus duab. Muab tus neeg mob tso rau hauv txoj hauj lwm sab nraud los yog supine, ua kom tag nrho qhov chaw ua haujlwm qis qis, thiab siv ultrasound los soj ntsuam thiab khij txoj kev khiav ntawm lub hom phiaj sib sib zog nqus hlab ntsha thiab ib puag ncig cov hlab ntsha tseem ceeb. Txais tawm - ntawm - dav hlau lossis hauv - dav hlau puncture hom raws li cov hlab ntsha faib cov yam ntxwv, ua rau cov koob echogenic maj mam, thiab saib xyuas cov koob nkag mus rau lub sijhawm ntawm cov duab ultrasound. Qhib lub paj hlwb stimulator, kho qhov kev siv tam sim no maj mam, thiab zoo -kho lub koob txoj hauj lwm kom txog rau thaum ib qho qis qis leeg nqaij contraction yog induced. Tom qab lees paub qhov tseeb ntawm qhov chaw ntawm rab koob, txhaj tshuaj loog hauv zos hauv batch nyob rau hauv kev soj ntsuam ultrasound kom ntseeg tau tias muaj kev sib txawv ntawm cov tshuaj nyob ib ncig ntawm lub paj hlwb sib sib zog nqus, thiab xyuas kom tsis muaj qhov cuam tshuam tsis zoo los ua kom tiav cov haujlwm.

5. Kev Paub Txog Kev Kho Mob

Ntev- daim ntawv thov kev kho mob lub sij hawm tshawb xyuas tias echogenic paj hlwb thaiv cov koob muaj qhov zoo tshaj plaws uas tsis tuaj yeem hloov tau hauv cov hlab ntsha qis qis. Rau cov neeg mob rog rog nrog BMI ntau dua 28, cov koob zoo tib yam muaj qhov sib sib zog nqus cov hlab ntsha ua tiav ntawm tsuas yog 65%, thaum siv cov koob tshuaj echogenic txhim kho nce qhov kev vam meej mus rau 96%. Lub tshuab muab ob npaug rau qhov ua tau zoo txo ​​qhov qhov muag tsis pom kev ntawm cov ntaub so ntswg sib sib zog nqus, txo qhov tshwm sim ntawm vascular raug mob thiab hematoma teeb meem los ntawm ntau dua 70%, thiab zam tsis tiav thaiv los ntawm cov paj hlwb sib txawv. Cov ntaub ntawv kho mob qhia tau hais tias kev siv cov koob echogenic shortens cov tshuaj loog pib lub sij hawm ntawm qis kawg nkaus ntawm lub paj hlwb blocks los ntawm 30%, prolongs lub sij hawm zoo analgesia, thiab txo cov intraoperative cawm opioid ntau npaum. Lub caij no, ib qho -lub sij hawm puncture ua tau zoo npaum li cas yog zoo heev, txo lub sij hawm npaj ua hauj lwm thiab txhim kho tag nrho cov kev phais.

6. Cov ntsiab lus thiab sublimation

Qhov qis qis ntawm cov hlab ntsha sib sib zog nqus tau ntev dhau los ua ib qho teeb meem hauv cheeb tsam tshuaj loog vim qhov chaw ntawm cov hlab ntsha sib sib zog nqus, cov txheej txheem ib puag ncig cov ntaub so ntswg thiab cov duab yooj yim cuam tshuam. Cov cuab yeej puncture tsoos thiab ib qho kev taw qhia thev naus laus zis yog qhov nyuaj kom ua tau raws li qhov yuav tsum tau ua ntawm cov tshuaj loog meej thiab nyab xeeb. Echogenic paj hlwb thaiv koob cia siab rau siab -nrhiav kev ua kom zoo dua thev naus laus zis thiab dual-mode positioning system los rhuav tshem cov kev txwv ntawm cov ntaub so ntswg sib sib zog nqus duab thiab qhov chaw, ua kom paub tseeb, nyab xeeb thiab muaj txiaj ntsig tob paj hlwb. Nws tsis tsuas yog daws qhov mob ntawm qhov chaw kho mob ntawm qhov ua tau zoo tsawg thiab cov teeb meem loj ntawm cov kab mob qis qis hauv lub paj hlwb, tab sis kuj muab cov tshuaj loog ruaj khov thiab txhim khu kev qha rau cov kev phais sab hauv sab hauv orthopedic, zoo heev txhim kho qib ntawm kev kho mob hauv cheeb tsam tshuaj loog.

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

Nrog rau cov neeg laus thiab cov neeg rog rog ntau zuj zus mus rau qhov kev phais orthopedic qis qis, qhov kev thov kho mob rau siab -txoj kev sib sib zog nqus paj hlwb tau nce ib xyoos ib zaug. Nws raug nquahu kom txhim kho cov qauv khoom lag luam ntxiv, txhim kho ultra- ntev txhim kho echogenic koob rau ultra- cov hlab ntsha sib sib zog nqus ntawm txoj kev phais lub duav thiab pelvic. Cov tsev kho mob yuav tsum tsim tshwj xeeb kev ua haujlwm tshwj xeeb rau cov hlab ntsha sab hauv qis nrog cov koob echogenic, ua cov phiaj xwm kev cob qhia rau cov kws tshuaj loog ntawm kev sib sib zog nqus sib sib zog nqus thiab dual -mode positioning skills. Tsis tas li ntawd, ntxiv dag zog rau kev soj ntsuam cov ntaub ntawv khaws cia thiab kev tshawb fawb, tshawb nrhiav cov tshuaj zoo tshaj plaws thiab cov tshuaj loog rau cov pab pawg neeg mob sib txawv, thiab txhim kho qhov tseeb thiab kev nyab xeeb ntawm cov hlab ntsha sib sib zog nqus.