慢性难愈合创面多发生于感染、创伤、烧伤、糖尿病、静脉曲张、动脉硬化及截瘫等患者,其发病率与年龄呈正相关,病理机制复杂,病程长,需要多学科联合治疗[1].研究表明,封闭负压引流技术(VSD)能够改善创面血供,减轻局部组织水肿,促进创面愈合,可为后期修复手术创造条件[2],已被广泛应用于骨科、普外科、整形外科及烧伤外科等领域[3].重组人碱性成纤维细胞生长因子(rh-bFGF)与人体内源性碱性成纤维细胞生长因子(bFGF)完全相同,能够刺激成纤维细胞、血管内皮细胞的增殖,进而达到修复创面的目的[4].本文旨在探讨VSD联合rh-bFGF治疗慢性难愈合创面的效果,报道如下.

目的:探讨应用游离股前外侧皮瓣（ALTF）移植修复小腿及足踝部软组织肉瘤切除术后创面的临床疗效。方法:回顾性分析2013年9月-2022年1月丽水市中心医院整形（修复重建）外科收治的7例小腿及足踝部软组织肉瘤患者的临床资料，其中男3例，女4例；年龄38~61岁，平均47岁；软组织肉瘤位于右侧足底3例，左小腿3例，右小腿1例。病理检查提示肿瘤分级均为低级别肉瘤。肿瘤扩大切除术后创面一期行游离ALTF修复，缺损创面大小为6.0 cm×6.0 cm~12.0 cm×6.0 cm，皮瓣切取面积7.0 cm×6.0 cm~15.0 cm×8.0 cm。将皮瓣中旋股外侧动脉降支的近端与胫前动脉或胫后动脉近端吻合，伴行静脉与其相应伴行静脉相吻合，旋股外侧动脉降支的远端结扎或与胫前动脉或胫后动脉的远端吻合，股外侧皮神经与受区皮神经相缝接，供区创面通过"Z"字改形或局部皮瓣转移等方式直接缝合关闭。术后定期、规律门诊随访并分析临床疗效。结果:术后随访时间为1~6年，平均3.5年，7例患者皮瓣成活良好，小腿及足底非负重区外观满意，行走功能良好。局部肿瘤无复发，无他处转移。对皮瓣及治疗效果的满意度进行患者调查，均为满意。结论:ALTF穿支位置相对稳定、可靠，利用游离ALTF移植修复小腿及足踝部软组织肉瘤切除术后创面的临床效果良好，值得推广。

后天造成屈指畸形的原因很多,包括肌腱损伤、皮肤缺损、疤痕挛缩等[1-2].矫正陈旧性屈指畸形往往需要修复皮肤软组织缺损,皮瓣则是修复手和手指复杂皮肤缺损的首选方法之一[3].其中,手指穿支血管的解剖和穿支皮瓣的设计被广泛研究和应用[4-5].

前臂大面积皮肤软组织缺损是临床常见的外伤性疾病,时常伴有骨、肌腱外露,常规植皮难以修复,皮瓣移植修复是解决此类创面的有效方案.股前外侧皮瓣由我国学者徐达传教授[1]在1984年首先报道,因其主干、穿支血管稳定,皮瓣可切取面积大及可携带感觉神经等诸多优点,已成为修复各种类型创面缺损的经典皮瓣,因而广泛应用于修复重建外科[2]、整形外科[3]、口腔颌面外科[4]等科室的实际临床工作中.本文回顾性分析2016年8月至2021年12月在浙江省丽水市中心医院修复重建手外科、整形外科治疗的8例前臂大面积皮肤软组织缺损患者,使用双侧游离股前外侧皮瓣切取瓦合移植修复,供区创面Ⅰ期缝合,疗效满意,报道如下.

Objective:To investigate the clinical effect of using free bilateral anterolateral thigh flaps(ALTF) in series to repair large area soft tissue defects of forearm.Methods:The clinical data of 11 patients with large soft tissue defects of forearm admitted in the Department of Plastic(Repair and Reconstruction) Surgery, Lishui Hospital of Zhejiang University from March 2014 to December 2021 were retrospectively analyzed, including 8 males and 3 females. Aged 36 to 68 years old, with an average of 48 years old. VSD treatment was performed after debridement, and until fresh removed 3 to 5 days after the operation. Until the wound was fresh. The wound was repaired with free bilateral ALTF in series until fresh. The size of the forearm wound was 18 cm×15 cm-28 cm×13 cm. The cut area of a single flap was 10 cm×8 cm-20 cm×13 cm. The series of bilateral flaps: One of the flaps was used as the proximal flap, and its vascular pedicle was anastomosed with the arteries and veins of the recipient area. The other flap was used as the distal flap, and the arteries and veins between the 2 ALTFs on both sides were anastomosed. The vascular pedicle beyond the distal flap was ligated or anastomosed to the distal end of the ulnar artery or the distal end of the radial artery. The flap and the surrounding skin of the recipient area were sutured immediately. The donor sites of the flap was closed directly. Periodic and regular outpatient follow-up was performed after operation and the clinical efficacy was analyzed.Results:All the flaps successfully survived after the surgery. The postoperative follow-up lasted for 6-18 months, 12 months in average. The flaps survived well with good soft texture, without swelling, the capillary reaction time was normal, without surface ulceration, in rosy colour and restored protective sensations. The hand function of the affected limb recovered well. The wound at donor sites healed well without complications. At the last follow-up, the hand function of the affected limb was evaluated by the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, the result was 7 in excellent and 4 in good. The patients were satisfied with the flap and the therapeutic effect.Conclusion:The free bilateral ALTF in series can be used to repair a wound surface with large area, and the donor site can be closed at the same time. It is an effective method to repair large soft tissue defect of forearm.

足部创面缺损常遗留骨骼、肌腱外露,常规植皮不易成活,皮瓣修复是解决此类创面的有效方法.局部皮瓣只能修复邻近微小创面,因足部皮肤移动性差且周围皮肤软组织少,使得局部皮瓣修复此类创面时受到很大限制[1].带蒂皮瓣如腓肠神经营养皮瓣修复足部创面后形成蒂部猫儿隆起且皮瓣臃肿明显影响受区美观,再者因供区破坏大,其在足部创面的应用也明显受限[2].回顾性分析2013年1月至2021年6月浙江省丽水市中心医院收治的11例足部创面皮肤软组织缺损患者,使用游离髂腹股沟皮瓣切取移植修复,供区创面一期缝合,疗效满意,报道如下.

目的 探讨使用臭氧水联合负压封闭引流装置(NPWT)治疗wagner3～4期糖尿病足溃疡患者的安全性和有效性.方法 50例wanger3～4期糖尿病足溃疡患者,均使用臭氧水联合NPWT进行治疗,观察记录治疗后4、9、14及21d创面大小、肉芽生长情况、上皮化情况及创面细菌阴性率.结果 所有患者创面均愈合良好.在21d时可观察到肉芽生长良好,上皮化加速,第21天的创面细菌检出阴性率100％,治疗效果满意.结论 采用臭氧水联合NPWT治疗wagner3～4期糖尿病足溃疡疗效显著,安全性高,易操作,特别在不能耐受手术的患者中有较好的应用前景.

目的 探讨应用微血管吻合器在游离股前外侧皮瓣修复足踝部皮肤软组织缺损中的疗效分析.方法 回顾性分析2018年1月至2020年6月间36例在本院住院并接受游离股前外侧皮瓣修复足踝部皮肤软组织缺损患者的临床资料,根据静脉血管吻合方式不同,将其分为吻合器组(18例)和手工组(18例),吻合器组皮瓣中的两条静脉应用微血管吻合器行端端吻合,手工组中患者的两条静脉手工行端端吻合.所有动脉均手工行端端吻合.结果 应用微血管吻合器静脉吻合的时间为(12.3±1.1)分钟,较手工吻合时间(24.4±2.2)分钟明显缩短,差异具有统计学意义(P<0.001).微血管吻合器组术后静脉通畅,未见血栓形成,术后皮瓣血运良好;手工吻合组有2例皮瓣静脉血栓形成导致血管危象.吻合器组术后血管吻合通畅率为100％,手工组术后血管通畅率为89％.结论 微血管吻合器在游离股前外侧皮瓣修复足踝部皮肤软组织缺损中吻合口通畅、操作时间短,术后并发症少.

目的 探讨应用不同比例载药硫酸钙联合自体骨植入治疗感染性骨缺损的疗效分析.方法 2011年3月至2020年3月,收治感染性骨缺损患者共53例,所有患者病灶清除后骨缺损区均予载药硫酸钙联合自体骨植入.根据载药硫酸钙与自体骨植入比例分为1:2组(19例)与1:3组(34例),回顾性分析患者的术后创口引流管滞留时间,创面愈合时间及骨愈合时间,P<0.05为差异有统计学意义.结果 1:3组创面愈合时间(18.09±4.965天)显著少于1:2组(25.28±8.689天),差异有统计学意义(P<0.05);1:2组创口引流管滞留时间10.79±2.879天,1:3组11.50±2.620天;1:2组骨愈合时间17.88±2.488周,1:3组16.94±2.488周;两组在骨愈合时间上与拔出引流管时间上差异无统计学意义(P>0.05).1:2组治愈率78.9％,复发2例,1例清创后治愈,1例截肢.1:3组治愈率94.1％,1例感染复发后截肢.1:2组发生骨不愈合2例,1例骨搬移手术后治愈,1例截肢,骨不愈合率10.5％.1:3组骨不愈合1例,经骨搬移手术后治愈,骨不愈合率2.94％.结论 骨感染病灶清除后一期联合植入载药硫酸钙与自体骨是安全及有效的;且载药硫酸钙与自体骨植入比例为1:3更佳.

OBJECTIVE To evaluate the effect of one-stage treatment of bone morphogenetic protein 2 combined with Jifusheng in the experimental model of osteomyelitis in rabbits. METHODS The model of chronic osteomyelitis of tibia was established in 30 3-month-old male New Zealand white rabbits with a body weight of (2.0±0.5) kg, and the model was verified 4 weeks after operation. Thirty rabbits with osteomyelitis were randomly divided into 3 groups with 10 rabbits in each group (n= 10). The model group did not do any treatment after focal debridement, treatment group A was implanted with musculosheng at the site of focal debridement and bone defect, and treatment group B was implanted with apolipoprotein 2-Jifusheng at the site of focal debridement and bone defect. The therapeuticeffect was evaluated by blood biochemical, microbiological, imaging, pathological and immunohistochemical examination 8 weeks after operation. RESULTS At 4 weeks after operation, 30 rabbits with osteomyelitis were successfully validated. The results of serological examination showed that the hypersensitive C-reactive protein (CRP) and white blood cell count(WBC)in the model group were significantly higher than those in the blank group at 2 and 4 weeks after operation. Eight weeks after treatment, the detection of blood indexes showed that the white blood cell count (WBC)and hypersensitive C reactive protein (CRP)in treatment group A and treatment group B were significantly lower than those in the model group (P<0.05), but there was no significant difference between treatment group An and treatment group B (P>0.05). Eight weeks after treatment, the bone defect area was measured. The bone volume/total volume (BV/TV) and bone mineral density (BMD)in treatment group A and B were significantly higher than those in the model group (P<0.05), and the bone volume/total volume (BV/TV) and bone mineral density(BMD)in treatment group B were significantly higher than those in treatment group A (P<0.05), the repair of bone defect was almost complete, and the bone volume and bone mineral density increased significantly. At 8 weeks after treatment, the number of osteoblasts/bone tissue area (N.Ob/T.Ar) and the number of osteoblasts/bone tissue perimeter (N.Ob/B.Pm) in treatment group A and B were significantly higher than those in model group, and the N.Ob/T.Ar and N.Ob/B.Pm in treatment group B were significantly higher than those in treatment group A. The immunohistochemical staining of TNF- α and IL-6 around bone tissue in treatment group A and treatment group B was significantly less than that in model group, but there was no significant difference between treatment group B and treatment group A. CONCLUSION The combined application of apolipoprotein 2-Jifusheng can promote bone repair and reduce the inflammation of the focus. it can treat rabbits with osteomyelitis in one stage, provide objective basis for the formulation of clinical treatment strategy of osteomyelitis and further promote clinical research.

Objective:To compare the effect of stripped perforator pedicle on the survival of perforator flap.Methods:From January, 2015 to December, 2019, 44 patients with soft tissue defects of distal shank and ankle were repaired with perforating vessel pedicled propeller flap. According to the nudity of the perforator pedicle, the patients were divided into 2 groups: stripped group ( n=14) and non-stripped group ( n=30). The gender, age, history of smoking, history of diabetes, location of wound, size of flap, perforator artery of flap, closure method of donor site, degree of flap swelling 3 days after operation, percentage of survival area of flap 7 days after operation and postoperative complications were analysed retrospectively. Data were analyzed statistically. The difference was statistically significant when P<0.05. Results:There was no significant difference between the 2 groups in age, smoking history, diabetes history, wound location, size of flap, perforator artery and donor site closure( P<0.05). The degree of swelling of flap in the stripped group 3 days after operation [(+) 94.00%, (++) 6.00%, (+++) 0.00%, (++++) 0.00%)] was less than that in the non-stripped group [(+)47.00%, (++) 29.00%, (+++) 13.00%, (++++) 11.00%)] . The difference was statistically significant between the 2 groups( P<0.05). The percentage of flap survival area in the stripped group [(100.00±0.00) %] was higher than that in the non-stripped group [(88.23±21.29)%] , and the difference was statistically significant ( P<0.05). The incidence of postoperative complications in the stripped group(0.00%) was lower than that in the non-stripped group (39.00%). The difference heel statistically significant( P<0.05). Conclusion:The stripped pedicle of the perforating vessel can promote a better survival of the arterial perforating branch propeller flap, and the degree of postoperative swelling and complications of the flap are lower.

Objective:To investigate the relationship between serum fibroblast growth factor 21/23 level, trauma severity and prognosis in middle-aged and older adult patients with traumatic fracture.Methods:A total of 126 middle-aged and older adult patients with traumatic facture who received treatment in the Second People's Hospital of Lishui, China between June 2017 and June 2019 were included in the study group. Fifty healthy controls who concurrently received physical examination in the Second People's Hospital of Lishui were included in the control group. The study group was divided into five subgroups according to relevant criteria: mild, moderate, severe, poor prognosis and good prognosis. The levels of C-reactive protein (CRP), procalcitonin (PCT), FGF21 and FGF23 were measured.Results:On admission, serum CRP, PCT, FGF23, FGF2 levels in the study group were (19.18 ± 5.66) mg/L, (0.71 ± 0.20) μg/L, (79.75 ± 18.62)μg/L,(52.10 ± 16.34) μg/L, respectively, and they were significantly higher than those in the control group [ (7.60 ± 2.61) mg/L, (0.30 ± 0.11) μg/L, (40.18 ± 10.33) μg/L, (30.11 ± 10.19) μg/L, t = 18.888, 17.750, 18.336, 11.032, all P < 0.001). On admission, serum CRP, PCT, FGF23, FGF2 levels in the study group were (19.18 ± 5.66) mg/L, (0.71 ± 0.20) μg/L, (79.75 ± 18.62) μg/L, (52.10 ± 16.34) μg/L, respectively, and they were significantly increased at 1 day [(21.59 ± 4.53) mg/L, (0.79 ± 0.22) μg/L, (83.85 ± 19.07) μg/L, (55.18 ± 16.55) μg/L, t = 3.72, 3.29, 1.56, 1.56, P < 0.05, P < 0.05, P = 0.122, P = 0.122] and 3 days after surgery [(23.15 ± 3.16) mg/L, (0.80 ± 0.24) μg/L, (88.11 ± 19.80) μg/L, (59.70 ± 16.07) μg/L, t = 6.65, 3.12, 3.59, 3.77, all P < 0.05] , and significantly decreased at 7 days after surgery [(14.35 ± 4.02) mg/L, (0.52 ± 0.16) μg/L, (50.06 ± 15.50) μg/L, (32.18 ± 12.52) μg/L, t = 8.31, 8.58, 13.77, 11.11, all P < 0.001]. On admission, there were significant differences in serum CRP, PCT, FGF23, FGF21 levels between mild, moderate and severe groups ( F = 25.087, 15.851, 15.831 and 12.645, all P < 0.001). On admission, serum CRP, PCT, FGF23, FGF21 levels in the poor prognosis group were significantly higher than those in the good prognosis group ( t = 5.757, 4.984, 3.189 and 4.006, all P < 0.001). The receiver operating characteristic curve (ROC) analysis results showed that serum CRP, PCT, FGF23, FGF21 levels in patients with traumatic fracture on admission had a certain value in the prediction of poor prognosis. Combined detection of these four indexes had the highest value, with AUC (0.95 CI) of 0.877 (0.783-0.982). Conclusion:Serum FGF21 and FGF23 levels have a certain value in the prediction of severity and prognosis of traumatic fracture in middle-aged and older adult patients.

手指皮肤完全脱套伤是手部严重损伤的一种特殊类型[1].当手指被机器或重物卡住时,患者会立即将手指向后拉,造成手指皮肤、皮下组织与骨、关节和肌腱分离.常合并指固有动、静脉及神经的不同平面的旋转撕脱损伤,导致血管内膜、神经束损伤严重,是手显微外科界的难题之一[2-3].传统认为不宜做再植手术,多采用各种皮瓣进行修复.然而皮瓣修复对供区造成新的创伤,且修复指体外观臃肿、功能差[4].所以,手指皮肤完全脱套伤的组织瓣若具备再植可能,应首先考虑再植术[5].2017年1月—2020年10月浙江大学丽水医院对11例13指手指皮肤完全套脱伤患者进行再植治疗,现报道如下.

小腿远端及足踝部创面多伴有骨、肌腱外露,游离植皮不易成活,皮瓣修复是解决此类创面的有效方法.皮瓣的选择很多,包括局部筋膜皮瓣、肌皮瓣以及带主干血管游离皮瓣移植等[1-3].近年来"穿支皮瓣"的应用受到青睐,符合"缺什么补什么"的重建原则[4-5].然而传统带蒂穿支皮瓣修复创面易造成蒂部猫耳隆起.日本Hyakusoku等[6]发明的穿支血管蒂螺旋桨皮瓣可以很好地解决蒂部美观问题,但皮瓣有一定的坏死率[7-8].我院通过改良手术方式,将螺旋桨皮瓣穿支血管蒂裸化,既能消除传统带蒂穿支皮瓣的猫耳隆起,又能促进穿支螺旋桨皮瓣的存活,临床效果满意.

Background: Spinal cord injury (SCI) is a severe devastating condition associated with serious disability and neurologic deficits. Aberrant micro RNA (miRNA) expression has been related to a variety of central nervous system diseases including SCI. In the present study, we aimed to discover the role of miR-129-5p on SCI. Material/Methods: An acute SCI rat model was induced, following the modified Allen method. A total of 36 rats were randomly assigned into 4 groups (n=9 in every group): Sham group; Model group (SCI+saline); SCI+NC group; and SCI+miR-129-5p group (100 nm solution, every 2 days). Basso-Beattie-Bresnahan (BBB) locomotor rating score was carried out to determine functional recovery. TUNEL (terminal dUTP nick-end labeling) staining was used to evaluate cell apoptosis. Hematoxylin and eosin staining was performed to assess the pathological state of spinal cord. Furthermore, western blot assay was conducted to measure the calpain1 and calpain2 expression. Results: Our data suggested that the expression level of miR-129-5p was markedly reduced in rats after SCI. Then miR-129-5p mimic was injected into the vertebral canal. We found that the SCI+miR-129-5p group had a high score in the BBB test compared with the SCI+NC group and the Model group. The overexpression of miR-129-5p obviously reduced tissue loss, damaged cells, and the number of TUNEL positive cells. Moreover, western blot assay exhibited that overexpression of miR-129-5p decreased calpain1, calpain2, and cleaved caspase-3 expression. Conclusions: Our findings suggested that overexpression of miR-129-5p improved neurological function by promoting functional recovery, reducing tissue loss and cell apoptosis in rats in an SCI model, possibly through downregulation of calpain1 and calpain2.

Bone nonunion remains a challenge during the treatment of bone defect accompanied with infection. Epimedii herba is a widely used medicine in clinic to enhance bone healing. Epimedin C and icariin are the major flavonoid glycosides from Epimedii herba. Although the effects of these compounds have been reported, their different absorption and utilisation by osteoblasts remain unclear. In the present study, lipopolysaccharide (LPS)-induced osteoblast was adopted as the model cell to evaluate the effects of epimedin C and icariin. The intracellular and extracellular drug concentrations within 24 h were assayed by pipette tip solid-phase extraction and high-performance liquid chromatography, respectively. MTT, alkaline phosphatase (ALP) and calcified nodule staining were performed to identify and evaluate the effects of epimedin C and icariin on LPS-induced osteoblasts. The regulatory roles of epimedin C and icariin in the bone morphogenetic protein-2 (BMP-2)/Runtrelated transcription factor 2 (Runx2) signalling pathway were investigated. The results revealed that epimedin C and icariin were not efficiently absorbed by LPS-induced osteoblasts. Nevertheless, they still had high utilisation efficiency after entering the cells. ALP activity, mineralisation and osteoblasts proliferation were enhanced by a high concentration of epimedin C and icariin. The suppressed expression of BMP-2 and Runx2 in LPS-induced osteoblasts was up-regulated significantly after treatment with epimedin C and icariin. These findings firstly illustrated the behavior of epimedin C and icariin from Epimedii herba on LPS-induced osteoblasts and the regulatory property on the expression of key genes and proteins of the BMP-2/Runx2 signalling pathway, which might be helpful for better understanding flavonoids' mechanism to enhance bone repair and improving their future application.

手指皮肤软组织缺损在修复重建、手外科的临床工作中十分常见.手指小的创面,以往有多种修复方法,比如指侧方逆行岛状皮瓣、指掌侧推进皮瓣、指背筋膜蒂皮瓣、邻指皮瓣、V-Y推进皮瓣、第一掌背皮瓣等.传统的修复方式其供区常需植皮,影响美观,有时甚至会影响术后的功能.游离组织移植具有供区损伤小,术后外观好的特点,近来有学者主张其是手部组织缺损的首选方法[11,我院自2016年5月-2017年5月应用游离腕横纹皮瓣修复手指皮肤软组织缺损8例,均获得满意的效果,现报道如下.

目的 探讨超声引导下前路坐骨神经+股神经联合阻滞用于膝关节以下改良穿支皮瓣V-Y术患者的麻醉效果.方法 选择2015年10月~2017年10月在庆元县人民医院和丽水市中心医院择期实施改良穿支皮瓣V-Y术的患者74例,随机分为前路超声引导下前路坐骨神经+股神经阻滞组(观察组)与单纯硬膜外阻滞组(对照组),每组37例.监测记录两组患者感觉神经阻滞起效时间、持续时间及操作时间;并用视觉模拟评分(VAS)法记录患者术后1h、4h、12h、24h的静息时疼痛强度及麻醉操作摆放时疼痛评分,监测两组患者麻醉前和麻醉后10、30 min及术毕、术后12 h的收缩压、舒张压、心率变化;术后首次进食时间,术后24 h内并发症、患者总体满意度等.结果 麻醉后对照组患者SBP、DBP、HR显著低于麻醉前,与观察组比较,差异有统计学意义(P<0.05).观察组操作时体位变动疼痛评分显著降低,术后镇痛维持时间较长,患者总体满意度高,与对照组比较,差异有统计学意义(P<0.05).观察组术后并发症发生率也显著低于对照组,差异有统计学意义(P<0.05),但在术中止血带的耐受情况上观察组比对照组耐受性差,差异有统计学意义(P<0.05).结论 采用超声引导下坐骨神经+股神经联合阻滞用于膝关节以下改良穿支皮瓣V-Y术患者,操作方便,并发症少,麻醉效果好.

目的 探讨超声引导上臂中段神经阻滞对前臂改良穿支皮瓣V-Y治疗患者术后肢端运动功能恢复的影响.方法 选择2015年2月～2017年8月在丽水市中心医院和遂昌县人民医院择期行前臂改良穿支皮瓣V-Y治疗患者84例,采用随机数字表法将其分为A、B两组(n=42).A组采用两点法行超声引导上臂神经阻滞;B组采用一点法超声引导锁骨上臂丛神经阻滞.术中监测并记录两组患者在不同神经支配区域药物阻滞起效时间、感觉、功能恢复时间、肩和肘关节运动恢复时间以及术后患者满意度、不良反应等.结果 两组患者术中、术后均未发生严重不良反应,但在注药后30 min患者VAS评分、注药后超声定位神经阻滞成功率以及术后患者满意度评价方面,A组与B组比较差异有统计学意义(P＜0.05).两组患者在超声定位神经阻滞穿刺操作后起效时间、术后患者肘关节及肩关节运动功能恢复时间方面,A组与B组比较差异有统计学意义(P＜0.05);但两组患者在感觉功能恢复时间上比较差异无统计学意义(P＞0.05).结论 超声引导上臂神经阻滞能较大限度保留肩关节、肘并节的运动功能,提高患者的满意度.