外周神经阻滞课件.pptx

1、This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller a

2、nd DS18B20 temperature sensor.外周神经阻滞外周神经阻滞佘乾斌佘乾斌 陈婕陈婕2016-04-18This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.

3、The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.外周神经阻滞具有对机体影响小、恢复快、节省医疗费用等优点，有阻滞不全、患者紧张等缺点。超声定位法神经电刺激法盲探异感法超声可实时的观察目标神经的局部结构、穿刺针的行进路线、局麻药的扩散，最大程度保证效果，减少患者不适和并发症。This paper mainly introduces the design of an intelligent temperature control system which rea

4、lizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.神经刺激仪神经刺激仪This paper mainly introduces the design of an intellig

5、ent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introd

6、uces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature s

7、ensor.高频探头高频探头（6-13MHZ）优点：清晰度好。缺点：穿透力弱。适用于浅部浅部神经，如臂丛。低频探头低频探头（2-5MHZ）优点：穿透力强；缺点：清晰度低。适用于深部深部神经，如坐骨神经。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor

8、DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.神经及周围结构的超声回声表现神经及周围结构的超声回声表现 组织超声成像静脉静脉压缩性无回声（黑色）压缩性无回声（黑色）动脉动脉搏动性无回声（黑色）搏动性无回声（黑色）脂肪低回声（黑色）筋膜高回声（白色）肌肉低回声及高回声条带条带（黑色及白色）肌腱高回声（白色）神经神经低回声（黑色）低回声（黑色）神经内、外膜高回声（白色）局麻药无回声（黑

9、色）。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontrolle

10、r and DS18B20 temperature sensor.操作基本手法与技巧操作基本手法与技巧 四个操作手法：P：向探头施加压力，使目标更清晰。A：依照神经走形滑动探头。R：旋转探头，显示神经横纵截面。T：倾斜探头，使声束与神经垂直。辨方向：移动或翘起探头一侧，辨别内外侧。辩标志：辨别图像中的标志性结构：血管、肌肉、骨骼。辩目标：根据标志性结构和目标神经的局部解剖关系、神经纵截面和横切面的不同超声图像特征，确定目标神经。This paper mainly introduces the design of an intelligent temperature control system

11、 which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声探头、穿刺针和目标结构三者的相对关系，超声引导下的神经阻滞可分为长轴/短轴平面内技术和长轴/短轴平面外技

12、术。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller

13、 and DS18B20 temperature sensor.超声引导下上肢外周神经阻滞超声引导下下肢外周神经阻滞This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The c

14、ore components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下上肢外周神经阻滞超声引导下上肢外周神经阻滞肌间沟入路臂丛神经阻滞锁骨上入路臂丛神经阻滞锁骨下入路臂丛神经阻滞腋窝入路臂丛神经阻滞This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and

15、 control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.臂丛神经臂丛神经解剖解剖臂N丛是由C5-C8及T1脊神经前支组成，少部分C4和T2前支的小分支也有参与。各神经根分别由相应的椎间孔发出，穿出前、中斜角肌间隙后分为上中下三干。三干+锁骨下血管形成锁骨下血管鞘，穿过第一肋和锁骨下

16、后形成三束并发出支配上肢的终末神经This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51

17、microcontroller and DS18B20 temperature sensor.总体来说，臂丛神经支配上肢的感觉和运动。肌间沟入路联合腋窝入路臂丛阻滞几乎可以完全阻滞上肢。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20

18、and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下肌间沟入路臂丛神经阻滞超声引导下肌间沟入路臂丛神经阻滞 患者常规监测、开放静脉通道，适当镇静（可给予咪达唑仑0.05mg/kg，芬太尼1ug/kg），吸氧，侧卧位，患侧在侧卧位，患侧在上。上。选择高频探头，深度调至2-3cm。将探头在环状软骨水平横置于颈部中央，然后向外侧移动，从内向外依次可以看到气管、甲状腺、颈总动脉、颈内静脉、前斜角肌、臂

19、丛和中斜角肌。臂丛表现为一串类似蜂窝状蜂窝状的回声组织。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system a

20、re AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The c

21、ore components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.在超声探头的外侧部穿刺，经中斜角肌推进，使针头位于臂丛的深部，回抽无回抽无血血后注射局麻药10-15ml，可观察到局麻药扩散。将针退至皮下，调整进针角度，将针尖推进至臂丛上方回抽无血回抽无血后再注射局麻药10-15ml。观察麻药扩散情况，直至臂丛完全被液性暗区包围。This paper mainly introduces the design of an intelligent temperature control s

22、ystem which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.肌间沟臂丛阻滞并发症肌间沟臂丛阻滞并发症膈神经阻滞喉返神经阻滞椎管内注射局麻药中毒颈交感神经节阻滞

23、气胸臂丛神经损伤This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcont

24、roller and DS18B20 temperature sensor.超声引导下腋路入路臂丛神经阻滞超声引导下腋路入路臂丛神经阻滞AA：腋动脉AV：腋静脉M：正中神经U：尺神经R：桡神经This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B

25、20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下腋路入路臂丛神经阻滞超声引导下腋路入路臂丛神经阻滞 患者常规监测、开放静脉通道，适当镇静，吸氧，平卧，头转平卧，头转向对侧，患肢外展向对侧，患肢外展90。在胸大肌和肱二头肌交接处（腋窝皮肤皱褶下缘），将探头长轴与腋动静脉和臂丛神经垂直。先寻找腋动脉。以腋动脉为中心，外上方外上方-正中神经，下方正中神经，下方-桡神经，内侧桡神经，内侧-尺

26、神经，外尺神经，外侧偏下方稍远处侧偏下方稍远处肌皮神经肌皮神经。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the syst

27、em are AT89C51 microcontroller and DS18B20 temperature sensor.This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.T

28、he core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.腋路臂丛阻滞并发症腋路臂丛阻滞并发症局麻药中毒 注射局麻药之前回抽回抽是避免局麻药中毒最有效的方法。This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by usi

29、ng single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下下肢外周神经阻滞超声引导下下肢外周神经阻滞股神经坐骨神经（Labat点入路）股外侧皮神经闭孔神经腰丛隐神经This paper mainly introduces the design of an intelligent temperature

30、control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.股神经解剖股神经解剖FI=髂筋膜髂筋膜 FL=阔筋膜阔筋膜 FS=股鞘股鞘 IP

31、M=髂腰肌髂腰肌 PECT=耻骨肌耻骨肌 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89

32、C51 microcontroller and DS18B20 temperature sensor.超声引导下股神经阻滞超声引导下股神经阻滞 适应症：大腿前面、股骨、膝关节手术。体位：平卧，患肢稍外展 探头位置：平行腹股沟韧带置于腹股沟之上。进针方向：外侧，推进至股神经深部。局麻药：5-10mlThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control

33、 by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下股神经阻滞超声引导下股神经阻滞FA：股动脉FV：股静脉FN：股神经This paper mainly introduces the design of an intelligent temperature control syste

34、m which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下股神经阻滞超声引导下股神经阻滞平面内进针法显现阻滞针到达股神经处 FA=股动脉 箭头=股神经FV

35、=股静脉 LA=局麻药 This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 micro

36、controller and DS18B20 temperature sensor.超声引导下坐骨神经阻滞超声引导下坐骨神经阻滞适应症：膝部、胫腓骨、踝关节和足部的外科手术。体位：平卧，患肢稍外展探头位置：与坐骨神经走向垂直进针方向：内侧/外侧。局麻药：15-20mlThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using singl

37、e bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下坐骨神经阻滞超声引导下坐骨神经阻滞 Labat点定位：在股骨大转子与髂后上嵴之间做连线，过其中点做连线的垂直线。此垂直线与股骨大转子和骶裂孔连线的交点。This paper mainly introduces the design of an intellige

38、nt temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下坐骨神经阻滞超声引导下坐骨神经阻滞Thi

39、s paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and

40、DS18B20 temperature sensor.超声引导下股外侧皮神经阻滞超声引导下股外侧皮神经阻滞 适应症：大腿前外侧至膝关节的皮肤，臀部外侧及坐骨粗隆下大腿上2/3的皮肤 探头位置：平行腹股沟韧带放置，探头外侧在髂前上棘部位。局麻药：3mlThis paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus dig

41、ital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下股外侧皮神经阻滞This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature meas

42、urement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.超声引导下闭孔神经阻滞超声引导下闭孔神经阻滞 适应症：在经尿道膀胱外侧壁切除术时抑制内收肌收缩，膝关节内侧手术操作。探头位置：在腹股沟韧带内侧1/3水平，并稍向头侧倾斜，耻骨肌下方。局麻药：3-5mlTh

43、is paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and

44、 DS18B20 temperature sensor.超声引导下闭孔神经阻滞超声引导下闭孔神经阻滞This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core comp

45、onents of the system are AT89C51 microcontroller and DS18B20 temperature sensor.其他局部麻醉其他局部麻醉This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 a

46、nd single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.局部浸润麻醉：沿手术切口分层注射局麻药，阻滞组织中的神经末梢。表面麻醉：将渗透作用强的局麻药与局部皮肤、黏膜接触，使其透过皮肤、黏膜而阻滞浅表神经末梢所产生的无痛状态。静脉局部麻醉：以一定容量局麻药充盈与神经伴行的静脉血管，局麻药可透过血管而扩散至伴行神经而发挥作用。This paper mainly introduces the design of a

47、n intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller and DS18B20 temperature sensor.局部浸润麻醉1.适用于病灶表

48、浅的手术，其最大的优势是患者意识清醒，对身体各项变化感受敏锐，经历手术操作时可与手术医师充分沟通，最大限度地避免功能区的损伤。2.局麻药的起效主要决定于pKa，pKa越小，麻醉起效越快。3.局麻药作用强度取决于脂溶性，脂溶性越高，作用越强。4.局麻药作用时间取决于蛋白结合力，蛋白结合率越高，作用时间越长。浓度浓度%最大剂量最大剂量mg/kg作用时效（作用时效（min）普鲁卡因0.5-1.0715-30氯普鲁卡因1.0-2.01130-60利多卡因0.5-1.04.560-120甲哌卡因0.5-1.04.560-120布比卡因0.25-0.53180-360罗哌卡因0.25-0.753180-3

49、60This paper mainly introduces the design of an intelligent temperature control system which realizes the function of temperature measurement and control by using single bus digital temperature sensor DS18B20 and single chip microcomputer.The core components of the system are AT89C51 microcontroller

50、 and DS18B20 temperature sensor.选择局麻药的注意事项选择局麻药的注意事项1、怀孕能增加神经对局麻药的易感性。2、由于其在胎盘的蓄积，怀孕妇女禁用甲哌卡因。3、布比卡因及依替卡因在同等剂量下有较高的心脏毒性。4、左旋布比卡因给药剂量与布比卡因相同，但心脏毒性较小。5、依替卡因运动阻滞强于感觉阻滞。6、大剂量的丙胺卡因可导致高铁血红蛋白血症。7、氯普卡因可被血浆中的胆碱酯酶快速水解。8、普鲁卡因代谢产物为对氨基苯甲酸，可能导致过敏反应。9、增加局麻药注射部位的灌注可加速药物的消除，并缩短作用时间，也将导致局麻药全身吸收量增大。局麻药中加入血管收缩药，如肾上腺素，可延