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1、超声技术原理basicultrasoundphysicsandtechnology•原理principlesofultrasoundtechnology•不同的人体解剖结构均有各自的反射特性differenthumananatomicalstructureshavevaryingreflectiveproperties•反射（回声）能够被超声探头收集thereflection(echo)iscollectedbytheprobe•反射的信号经放大处理后显示在数字监测仪上theamplitudeofreflec

2、tedsignalisdisplayedonadigitalmonitor超声技术原理Basicultrasoundphysicandtechnology•组织回声echogenicappearanceofvarioustissues•“高回声”结构－“亮”图像（如：骨、腱）“hyperechoic”structures－“bright”onscreen(e.g.bone,tendons)•“低回声”结构－“暗”图像（如：脂肪、血管）“hypoechoic”tissues－“dark”onscreen(e.g

3、.fat,vessels)•外周神经一般为高回声hyperechoicappearance等回声低回声高回声无回声超声频率frequency•高频超声higher-frequencyultrasound•高清晰度(分辨率),低穿透力higherresolution,lowpenetration•低频超声lower-frequencyultrasound•低清晰度、高穿透力lowerresolutiondeeperpenetration超声频率frequency•位置较浅神经superficialnerve•肌

4、间沟、腋路臂丛:10～13MHz•interscalene,axillarybrachialplexus•位置较深神经deepnerve•坐骨神经、腰丛:3～5MHz•sciaticnerve,lumbarplexus增益gain•增益amplifiergain•增加弱回声的振幅，以改善目标结构的图像质量•toincreasetheamplitudeoftheweakechoesandimprovethesignaltonoiseratio多普勒Dopplereffect•多普勒效应Dopplereffect

5、•血管结构的识别Identificationofvascularstructures探头transducers•探头transducers•线阵linear•凸阵curved超声引导区域麻醉Ultrasound-guidedregionalanesthesia(UGRA)•1978年LaGrange最早报道→超声下锁骨上臂丛阻滞UGRAwasfirstdescribedbyLaGrandeetal.in1978.BrJAnesth,1978,50:965-967•近十年来UGRA快速发展UGRAdevelop

6、edamoresignificantareaofinteresttoanesthesiologists–便携式portable–更精确morerefined–价格合理affordable超声引导区域麻醉的优点AdvantagesofUltrasoundGuidedPeripheralNerveBlocks项目优点神经直接可视定位有助于神经定位的周围结构直接可视直接可见局麻药注射时的扩散减少局麻药剂量安全性避免血管内或神经内注射避免创伤病人疼痛性肌收缩神经阻滞起效更快，作用更持久阻滞效果提高阻滞效果Adopte

7、dfromMarhoferetal2004