Daim ntawv thov ntawm Echogenic koob nyob rau hauv Upper Limb Peripheral Nerve Block Anesthesia

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

1. Cov Ntsiab Lus Kho Mob

Kev phais sab sauv suav nrog tes, dab teg, forearm thiab lub xub pwg arthroscopic cov txheej txheem vam khom hnyav rau ntawm peripheralpaj hlwb thaiv anesthesiaTxawm li cas los xij, cov txheej txheem kev kho paj hlwb ib txwm ntsib cov kev txwv tseem ceeb hauv kev kho mob. Pa qhov muag tsis pom kev puncture thiab zoo tib yam koob ultrasound kev taw qhia raug kev txom nyem los ntawm cov koob tsis zoo pom, tshwj xeeb tshaj yog nyob rau hauv ntiav cov ntaub so ntswg txheej nrog tawg me me paj paj. Cov kws kho mob feem ntau tawm tsam kom paub qhov txawv cov lus qhia los ntawm ib puag ncig fascia thiab cov ntaub so ntswg fibrous, ua rau muaj qhov sib txawv ntawm rab koob. Kev tso koob tsis raug ua rau cov hlab ntsha tsis tiav, lub sij hawm siv tshuaj loog ntev ntev, thiab muaj kev pheej hmoo ntawm cov tshuaj loog hauv zos. Tsis tas li ntawd, qhov muag tsis pom kev ua haujlwm yooj yim ua rau muaj kev raug mob vascular puncture, paj hlwb raug mob thiab tsim hematoma. Rau cov neeg mob uas nyias subcutaneous rog thiab ilv lub sab sauv paj paj tis, tsoos cov txheej txheem ntxiv elevate lub lag luam txaus ntshai, ua rau cov tshuaj loog tsis ruaj tsis khov, ntev postoperative rov qab thiab nce kev kho mob tus nqi.

2. Txoj Cai Ua Haujlwm ntawm Echogenic Nerve Block Needles

Echogenic paj hlwb thaiv cov koob sib xyaw ua ke ob lub thev naus laus zis ntawm hluav taws xob paj hlwb stimulation thiab tiag - lub sij hawm ultrasound kev taw qhia, hauv paus daws qhov kev pom thiab tso qhov tsis xws luag ntawm cov cuab yeej tsoo tsoos. Lub laser npav thiab electropolishing kev kho mob ntawm rab koob nto daim ntawv zoo li ncha- txhim kho cov qauv, uas tuaj yeem ua rau siab -brightness hyperechoic signals nyob rau hauv ultrasound scanning, paub tiag tiag- lub sij hawm pom tseeb ntawm tag nrho cov koob lub cev thiab rab koob tip trajectory. Meanwhile, lub built-nyob rau hauv hluav taws xob paj hlwb stimulation system kis tsawg-frequency micro-tam sim no los ntawm lub koob core. Thaum lub koob lub taub hau mus txog lub hom phiaj paj hlwb, nws ua rau cov leeg nqaij sib sib zog nqus thiab cov paj hlwb reflex cov lus teb, muab cov lus qhia meej hluav taws xob rau cov kws kho mob kom paub tseeb tias rab koob taw qhia. Lub dual- hom kev txheeb xyuas mechanism ntawm ultrasound pom kev pom thiab paj hlwb hluav taws xob teb tshem tawm qhov teeb meem ntawm qhov chaw uas tshwm sim los ntawm ib qho kev txwv, kom ntseeg tau tias rab koob taw qhia kom raug mus txog thaj tsam paj hlwb.

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

Raws li kev soj ntsuam puncture qhov tob thiab sab sauv paj hlwb faib cov yam ntxwv, echogenic paj hlwb thaiv cov koob tau muab faib ua ob lub ntsiab lus tseem ceeb: nplua - ntsuas qhov tob tob tob (22G-26G) thiab nruab nrab- ntsuas cov koob txhaj tshuaj (18G-21G). 22G-26G ultra-fine echogenic koob yog tsim rau cov kab mob sab sauv sab sauv sab sauv xws li cov paj hlwb nruab nrab, cov paj hlwb ulnar thiab radial paj hlwb hauv tes thiab dab teg phais. Lawv lub cev rab koob nyias ua rau cov ntaub so ntswg tsawg thiab yog qhov zoo tagnrho rau kev ua haujlwm me me me me. 18G-21G nruab nrab echogenic koob muaj cov qauv kev ruaj ntseg thiab kev ua haujlwm zoo dua, ua rau cov hlab ntsha sib sib zog nqus ntawm brachial plexus rau kev phais lub xub pwg thiab sab caj npab. Tag nrho cov koob txais cov khoom siv kho mob stainless hlau, nrog rau kev kho mob tsis muaj menyuam thiab qhov ntev customizable, tag nrho txuam nrog ntau hom kev phais sab sauv sab sauv tshuaj loog xav tau.

4. Cov Txheej Txheem Kev Ua Haujlwm

Ua ntej kev ua haujlwm, xaiv cov koob txhaj tshuaj raws li qhov chaw phais thiab tus neeg mob lub cev, thiab ua kom tiav cov tshuaj tua kab mob thiab ntsuas ntsuas ntsuas ultrasound. Muab tus neeg mob tso rau hauv lub nraub qaum lossis sab nraub qaum, kho qhov siab -ntau zaus linear ultrasound sojntsuam kom pom tseeb lub hom phiaj paj hlwb thiab ib puag ncig cov hlab ntsha thiab cov leeg nqaij. Txais yuav nyob rau hauv - txheej txheem dav hlau puncture txhawm rau txhawm rau txhawm rau echogenic koob maj mam, soj ntsuam qhov tseeb - lub sij hawm koob trajectory los ntawm ultrasound dluab, thiab tig rau cov paj hlwb stimulation ntaus ntawv kom tso zis tsawg - siv tam sim no. Kho lub koob txoj hauj lwm me ntsis kom txog rau thaum pom tseeb lub hom phiaj ntawm cov leeg nqaij contraction yog induced, paub meej tias lub koob taub yog ze rau lub hom phiaj paj hlwb. Tom qab paub tseeb tias tsis muaj ntshav rov qab los thiab tsis muaj qhov txawv txav ntawm cov paj hlwb stimulation, txhaj tshuaj loog hauv zos maj mam nyob rau hauv tiag - lub sij hawm ultrasound soj ntsuam xyuas qhov sib txawv ntawm cov tshuaj nyob ib ncig ntawm lub paj hlwb, thiab ua kom tiav qhov thaiv kev ua haujlwm tom qab lees tias tsis muaj tshuaj to lossis vascular infiltration.

5. Kev Paub Txog Kev Kho Mob

Nyob rau hauv kev kho mob batch daim ntawv thov, echogenic paj hlwb thaiv koob tau zoo optimized cov nyhuv ntawm sab sauv paj hlab ntsha thaiv tshuaj loog. Piv nrog rau cov koob zoo tib yam, lub ncha- txhim kho cov qauv zoo heev txhim kho qhov kev lees paub ntawm cov lus qhia ntawm rab koob hauv cov ntaub mos mos, txo cov sij hawm hloov kho ntau dua 60%. Kev tshawb xyuas dual thev naus laus zis zoo zam qhov tsis tseeb qhov chaw tshwm sim los ntawm ib qho kev sib txawv ntawm ultrasound imaging, thiab ib qho - lub sij hawm ua tiav puncture tus nqi ntawm brachial plexus thiab dab teg paj hlwb nce los ntawm 75% mus rau 98%. Clinically, nws pom tau hais tias cov hluav taws xob stimulation tawm tswv yim muaj peev xwm ua tau zoo txheeb xyuas cov paj hlwb me me uas nyuaj rau kev paub qhov txawv ntawm ultrasound ib leeg, txo qhov tshwm sim ntawm qhov tsis tiav ntawm 55%. Tsis tas li ntawd, kev xa tshuaj meej meej txo cov koob tshuaj loog hauv zos li ntawm 20%, txo qhov kev pheej hmoo ntawm cov tshuaj phiv tshuaj, thiab cov neeg mob tau pib tshuaj loog sai dua thiab ruaj khov intraoperative analgesia nyhuv.

6. Cov ntsiab lus thiab sublimation

Upper limb hlab ntsha thaiv cov tshuaj loog tso rau pem hauv ntej siab yuav tsum tau puncture precision thiab kev nyab xeeb kev khiav hauj lwm vim qhov zoo thiab ntom tis ntawm peripheral qab haus huv. Hom tshuaj tshuaj loog yog txwv los ntawm kev pom tsis zoo thiab qhov chaw tsis raug, uas tsis tuaj yeem ua tau raws li qhov siab -tus qauv qis qis thiab muaj kev nyab xeeb rau kev kho mob. Echogenic paj hlwb thaiv koob cia siab rau ob qhov txiaj ntsig ntawm ultrasound tiag tiag- lub sijhawm pom kev pom thiab hluav taws xob cov paj hlwb stimulation positioning, tawg los ntawm cov kev tsis sib haum xeeb ntawm cov cuab yeej tsoos tsoos. Nws tsis tsuas yog txhim kho qhov tseeb thiab kev vam meej ntawm cov hlab ntsha sab sauv, txo cov teeb meem ntawm kev phais, tab sis kuj ua kom cov neeg mob ua haujlwm tsis zoo thiab rov ua haujlwm tom qab ua haujlwm zoo, dhau los ua cov cuab yeej tseem ceeb rau niaj hnub sab sauv sab hauv cheeb tsam tshuaj loog.

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

Nrog txoj kev loj hlob sai ntawm kev phais qis qis qis qis qis thiab kev phais ib hnub, qhov kev thov kho mob rau siab -txoj hlab ntsha thaiv cov tshuaj loog tseem loj tuaj. Nyob rau hauv lub neej yav tom ntej, nws yog pom zoo kom txhawb ntxiv hierarchical daim ntawv thov ntawm echogenic koob, phim ultra- zoo specifications rau cov me nyuam sab sauv ceg phais thiab ilv minimally invasive phais, thiab nrov nruab nrab specifications rau niaj hnub orthopedic sab sauv ceg phais. Cov tsev kho mob yuav tsum ntxiv dag zog rau cov txheej txheem kev ua haujlwm rau cov kws kho mob, txhim kho kev ua haujlwm ntawm ob lub- hom kev ua haujlwm, thiab tsim kom muaj kev soj ntsuam daim ntawv thov kev soj ntsuam tiav. Lub caij no, ua kom cov khoom hloov kho dua tshiab, ua kom zoo dua cov txiaj ntsig zoo ntawm ultra- koob zoo, ntxiv txo cov nqaij ntshiv, thiab nthuav dav daim ntawv thov nyob rau hauv qhov kev tswj xyuas qhov mob ntawm sab sauv qaum ntev neuralgia.