星状神经节阻滞对桡骨骨折患者骨折愈合的影响  

Influence of stellate ganglion block on the healing of radial fracture in patients

作　　者：张风敏[1] 李志华[2] 郭斌[1] 柳顺锁[2] 刘志霞[1] 任天红[1] 

机构地区：[1]石家庄市第三医院麻醉科,050011 [2]河北医科大学第三医院麻醉科,050051

出　　处：《实用疼痛学杂志》2008年第5期337-340,共4页Pain Clinic Journal

摘　　要：目的研究星状神经节阻滞(SGB)治疗对上肢桡骨骨折愈合的影响。方法选择闭合型桡骨横断骨折患者60例,年龄20～45岁,ASAⅠ～Ⅱ级。无其他器质性疾病和代谢性疾病,随机分为2组(n=30),即SGB组和对照组。SGB组于切开复位内固定术后第2日开始至第14日,应用0.33%罗哌卡因6 ml行SGB治疗,隔日1次,共6次。于术后第14至第42日每隔2日1次,共8次。对照组术后除用骨肽、二代头孢类抗生素等常规治疗外,不进行SGB治疗。于术后第7日监测SGB组患者SGB后10、20、30、40、50、60 min时患侧桡动脉血流峰值速度及双前臂皮肤温差,以及对照组同时点数值。两组患者均于术后第14、28、42日拍摄X线片观察骨折愈合情况并进行分级评分;测定两组患者术后第1、14、28、42日血清中转化生长因子-β_1(TGF—β_1)浓度的变化。结果SGB治疗后,SGB组各时点患侧桡动脉的收缩期血流峰值速度均明显高于对照组(P<0.01)。SGB组各时点患、健侧皮肤温差明显高于对照组(P<0.01)。X线片示第14日时两组间骨折愈合评分差异无统计学意义;第28日时,SGB组X线片评分明显高于对照组(P<0.05);第42日时,SBG组评分明显高于对照组及28 d时(P<0.01)。术后第14、28、42日时,两组患者的TGF-β_1浓度均高于术后第1日(基础值)(P<0.01),其中28d时高于14及42 d时,而SGB组各时点的TGF-β_1浓度均高于对照组(P<0.01)。结论SGB治疗可促进上肢桡骨骨折愈合。Objective To investigate the influence of stellate ganglion block （SGB） on the healing of upper limb radius bone fracture. Methods Sixty patients with closed radius traverses fracture were chosen, aged 20-45 yr, ASA Ⅰ- Ⅱ , who were divided into two groups randomly： SGB group and controlled group （n=30）. From the 2nd day to 14th day, 0.33% ropivacaine was applied （6ml） in the SGB group, one time every two days,and one time every three days from 15th day to 42th day. SGB treatment were not carried in the control group. The change of both the blood stream speed of the radial artery in diseased side and the skin temperature difference in two groups were monitored during 7th day after opertion. The osteotylus of the two groups were investigated by X ray on 14th, 28th, 42th day after the operation. The changes of TGF-β1 in blood serum in the two group on 1, 14, 28 d after operation were determined. Results The radial artery blood stream speed in the SGB group was higher than that in the controlled group （P〈0.01）. The temperature difference between both upper limbs was bigger than that in the controlled group （P〈0.01）; On the 14, 28, 42d after the operation the osteotylus gradings by the X ray in the SGB group were higher than those in the controlled group （P〈0. 01）;On the 14th, 28th, 42th days the concentrations of TGF-β1 were higher in SGB group than those in the controlled group （P〈0.01）. Conclusion SGB treatment may promote the healing of upper limb fractures.

关 键 词：星状神经节阻滞 X线片 骨折愈合评分 血清中转化生长因子-β_1 

分 类 号：R683[医药卫生—骨科学]