[1]胡斌马涛周林杰秦宏玖**.局部麻醉无止血带技术在重度肘管综合征手术中的应用[J].中国微创外科杂志,2025,01(9):545-549.
　Hu Bin,Ma Tao,Zhou Linjie,et al.Application of Local Anesthesia Nontourniquet Technique in Surgery for Severe Cubital Tunnel Syndrome[J].Chinese Journal of Minimally Invasive Surgery,2025,01(9):545-549.
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局部麻醉无止血带技术在重度肘管综合征手术中的应用()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2025年9期
页码:
545-549
栏目:
临床研究
出版日期:
2025-09-25

文章信息/Info

Title:
Application of Local Anesthesia Nontourniquet Technique in Surgery for Severe Cubital Tunnel Syndrome
作者:
胡斌马涛周林杰秦宏玖**
(皖南医学院弋矶山医院手足外科，芜湖241000)
Author(s):
Hu Bin;  Ma Tao;  Zhou Linjie;  et al.
Department of Hand and Foot Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241000, China
关键词:
肘管综合征; 尺神经; 局部麻醉
Keywords:
Cubital tunnel syndrome; Ulnar nerve; Local anesthesia
文献标志码:
A
摘要:
目的探讨局部麻醉无止血带技术在重度肘管综合征手术中的应用效果。方法2020年7月~2023年6月我科采用局部麻醉无止血带技术治疗20例重度肘管综合征。以盐酸肾上腺素和生理盐水配比麻药，术区进行局麻后行尺神经原位松解，根据术中肘部尺神经的稳定性，选择是否行尺神经前置。结果13例行尺神经原位松解，7例因尺神经滑脱后改术式为尺神经筋膜下前置术。麻醉注射时仅第1针轻度疼痛［数字评定量表(Numeric Rating Scale，NRS)评分2～3分］，术中操作轻度疼痛(NRS评分1～2分)，术后有轻~中度疼痛(NRS评分1～6分)。术后所有患者均无麻醉不良反应，手术切口一期/甲级愈合。20例随访8～22个月，平均17.1月，根据顾玉东肘管综合征评定标准评定疗效：优5例，良12例，可3侧，优良率850%（17/20）。末次随访时患侧小指指腹两点辨别觉为4～7 mm，平均5.1 mm。结论局部麻醉无止血带技术行重度肘管综合征手术安全有效，值得临床推广应用。
Abstract:
ObjectiveTo explore clinical effects of local anesthesia nontourniquet technique in surgery for the treatment of cubital tunnel syndrome.MethodsBetween July 2020 and June 2023, 20 patients with severe cubital tunnel syndrome were treated by using local anesthesia nontourniquet technique. The local anesthetic was prepared, consisting of lidocaine with epinephrine, and in situ ulnar release was performed. Based on the evaluation for ulnar nerve instability,a decision was made on whether to perform anterior transposition of the ulnar nerve or not.ResultsIn situ ulnar release was performed in 13 cases and anterior subcutaneous transposition of the ulnar nerve due to ulnar nerve subluxation were conducted in 7 cases. During anesthesia injection, there was only mild pain in the first injection ［Numerical Rating Scale (NRS) score of 2-3 points］, mild pain during intraoperative procedures (NRS score of 1-2 points), and mild to moderate pain after surgery (NRS score of 1-6 points). No anesthetic complications were recorded and the wound healed well. All the cases were followed up for 8-22 months (mean, 17.1 months). According to classification of cubital tunnel syndrome introduced by Gu Yudong, the results were excellent in 5 patients, good in 12 patients and fair in 3 patients, with an excellent and good rate of 85.0%(17/20). At the last follow up visit, the 2point discrimination of the little finger was 4-7 mm (mean, 5.1 mm).ConclusionThe local anesthesia nontourniquet technique is safe and effective in surgery for the treatment of severe cubital tunnel syndrome, being worthy of clinical application.

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备注/Memo

备注/Memo:
基金项目：皖南医学院引进人才专项科研启动基金（YR202219）；安徽省高校自然科学杰出青年科研项目（2023AH020050）；皖南医学院校中青年科研基金（WK2024ZQNZ45，WK2024ZQNZ38）**通讯作者，Email：qin.hongjiu@163.com
更新日期/Last Update: 2025-10-17