超声引导下星状神经节阻滞对颅内动脉瘤夹闭术患者血流动力学及应激反应的影响  

Effects of ultrasound-guided stellate ganglion block on hemodynamics and stress response of intracranial aneurysm clipped patients

作　　者：尚平平[1] 刘晓宁 范军朝[1] 庞红利[1] 陈勇[1] 宋直雷[1] SHANG Pingping;LIU Xiaoning;FAN Junchao;PANG Hongli;CHEN Yong;SONG Zhilei(Department of Anesthesia and Perioperative Medicine,the First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China;Department of Heart Disease,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng,Henan 475000,China)

机构地区：[1]河南大学第一附属医院麻醉与围术期医学科,河南开封475000 [2]开封市中医院心病科,河南开封475000

出　　处：《中国医学工程》2022年第4期19-22,共4页China Medical Engineering

基　　金：开封市科技发展计划项目(1603082)。

摘　　要：目的探讨超声引导下星状神经节阻滞(SGB)对颅内动脉瘤夹闭术患者血流动力学及应激反应的影响。方法选择2019年6月至2021年1月在河南大学第一附属医院择期行颅内动脉瘤夹闭术的患者52例,随机数字表法分为SGB组和对照组,每组26例,SGB组于全身麻醉前行SGB,对照组在同一位置注射等量生理盐水。统计记录两组全身麻醉前(T_(1))、气管插管即刻(T_(2))、手术切皮即刻(T_(3))、术毕(T_(4))时的平均动脉压(MAP)和心率(HR);检测各时间点的血清皮质醇、去甲肾上腺素和肾上腺素水平。结果SGB组T_(2)~T_(4)各时间点的MAP及HR水平均低于对照组(P<0.05);SGB组T_(2)~T_(4)各时间点血清皮质醇、去甲肾上腺素及肾上腺素均低于对照组(P<0.05)。结论超声引导下SGB能有效减轻颅内动脉瘤夹闭术患者的应激反应,维持患者血流动力学稳定。【Objective】To investigate the effects of ultrasound-guided stellate ganglion block(SGB)on hemodynamics and stress response in patients underwent intracranial aneurysm clipping.【Methods】Fifty-two patients underwent elective intracranial aneurysm clipping in the First Affiliated Hospital of Henan University were selected and divided into SGB group and control group by random number table method,with 26 patients in each group.SGB group was performed with SGB before general anesthesia,and the control group was injected with the same amount of normal saline at the same position.Mean arterial pressure(MAP)and heart rate(HR)before general anesthesia(T_(1)),immediately after endotracheal intubation(T_(2)),immediately after skin resection(T_(3))and after surgery(T_(4))were recorded.Serum cortisol,norepinephrine and epinephrine levels were measured at each time point.【Results】The MAP and HR levels of SGB group at each time point from T_(2) to T_(4) were significantly lower than those of control group(all P<0.05).Serum cortisol,norepinephrine and epinephrine in SGB group were significantly lower than those in control group at each time point from T_(2) to T_(4)(all P<0.05).【Conclusion】SGB under ultrasound guidance can effectively reduce the stress response of patients undergoing intracranial aneurysm clipping and maintain the hemodynamic stability of patients.

关 键 词：星状神经节阻滞 颅内动脉瘤夹闭术 血流动力学 应激反应 

分 类 号：R614.4[医药卫生—麻醉学]