星状神经节阻滞治疗梅尼埃综合征的临床疗效  

Clinical effects of stellate ganglion block in the treatment of patients with Meniere's syndrome

作　　者：蔡鸿恩 刘多虎 董跃峰 藺玉琴 Cai Hong'en;Liu Duohu;Dong Yuefeng;Lin Yuqin(Department of Emergency,Wuwei Second People's Hospital,Wuwei City,Gansu Province 733009,China;Department of Anesthesiology,Wuwei Second People's Hospital,Wuwei City,Gansu Province 733009,China;Department of Ophthalmology and Otorhinolaryngology,Wuwei People's Hospital,Wuwei City,Gansu Province 733000,China;Department of Emergency,Wuwei Chinese Medicine Hospital,Wuwei City,Gansu Province 733000,China)

机构地区：[1]武威市第二人民医院急诊科,甘肃省武威市733009 [2]武威市第二人民医院麻醉科,甘肃省武威市733009 [3]武威市人民医院五官科,甘肃省武威市733000 [4]武威市中医医院急诊科,甘肃省武威市733000

出　　处：《中华疼痛学杂志》2020年第6期503-506,共4页Chinese Journal Of Painology

基　　金：甘肃省武威市2019年市立科研项目(WW190173)。

摘　　要：目的探讨星状神经节阻滞对梅尼埃综合征的治疗效果。方法收集2016年12月至2019年5月于武威市第二人民医院急诊科、武威市人民医院五官科和武威市中医院急诊科住院与留院观察治疗的梅尼埃综合征患者180例,按奇偶数法分为药物治疗组和神经阻滞组,每组90例。药物治疗组给予镇静、血管扩张药等传统治疗;神经阻滞组使用0.75%罗哌卡因10 ml+地塞米松5 mg+维生素B120.5 mg进行星状神经节阻滞治疗,左右侧交替,隔日治疗1次,5次为1疗程。观察两组患者治疗5、10 d及治疗后6个月时眩晕、视物旋转、恶心、呕吐及耳鸣、耳聋发作情况,比较两组治疗的总有效率。结果两组梅尼埃综合征患者的一般资料比较,差异均无统计学意义(P均>0.05)。治疗后第5、10日及6个月时,神经阻滞组优效率分别为[47.8%(43/90例)、92.2%(83/90例)、80.0%(72/90例)],均较药物治疗组[30.0%(27/90例)、74.4%(67/90例)、52.2%(47/90例)]高,差异均有统计学意义(P均<0.05);神经阻滞组总有效率分别为[87.8%(79/90例)、96.7%(87/90例)、88.9%(82/90例)],均较药物治疗组[67.8%(61/90例)、87.8%(79/90例)、70.0%(63/90例)]高,差异均有统计学意义(P均<0.05);治疗后6个月内神经阻滞组复发率为5.6%(5/90例)低于药物治疗组17.8%(16/90例)。结论星状神经节阻滞治疗梅尼埃综合征具有效果好、复发率低的优点。Objective To investigate the therapeutic effect of stellate ganglion block on patients with Meniere's syndrome.Methods From December 2016 to May 2019,in Department of Emergency,Wuwei Second People's Hospital,Department of Ophthalmology and Otorhinolaryngology,Wuwei City People's Hospital,and Department of Emergency,Wuwei Chinese Medicine Hospital,one hundred and eighty patients with Meniere's syndrome were enroll and randomly divided into traditional drug treatment group and nerve block group,90 cases in each group.Patients were given sedation,vasodilators and other traditional treatments in the traditional drug treatment group,while patients were treated by stellate ganglion block with 0.75%ropivacaine 10 ml+dexamethasone 5 mg+vitamin B120.5 mg in the nerve block group.The block was given once every two days aternating left and right,and 5 times as a course.Results There was no significant difference in general data between the two groups(all P>0.05).The excellent effect was 47.8%(43/90 cases),92.2%(83/90 cases),80.0%(72/90 cases)at the 5 days,10 days and 6 months after the treatment in the nerve block group,which were higher than those 30.0%(27/90 cases),74.4%(67/90 cases),52.2%(47/90 cases)in the drug treatment group,with significant difference(all P<0.05).The total effective rate was 87.8%(79/90 cases),96.7%(87/90 cases),88.9%(82/90 cases)at the 5 days,10 days and 6 months after the treatment in the nerve block group,compared with those 67.8%(61/90 cases),87.8%(79/90 cases),70.0%(63/90 cases)in the drug treatment group,with significant difference(all P<0.05).The recurrence rate in 6 months after the treatment was 5.6%(5/90 cases)in the nerve block group,which was lower than that 17.8%(16/90 cases)in the drug treatment group.Conclusion Both the ganglion nerve block and drug treatment can effectively treat Meniere's syndrome,but the effect of former is better with low recurrent rate.

关 键 词：星状神经节 神经传导阻滞 治疗 梅尼埃综合征 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]