星状神经节阻滞对全麻下感染性休克患者术中及术后早期生命体征变化的影响  

Effect of Stellate Ganglion Block on Intraoperative and Early Postoperative Vital Signs in Patients with Septic Shock Under General Anesthesia

作　　者：陈爱芳[1] 袁应川[1] 王龙[1] 王闯 汪艳萍[1] Chen Aifang;Yuan Yingchuan;Wang Long(The Second Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830063,China.)

机构地区：[1]新疆医科大学第二附属医院,新疆乌鲁木齐830063

出　　处：《四川医学》2022年第12期1209-1213,共5页Sichuan Medical Journal

摘　　要：目的观察星状神经节阻滞(SGB)对全麻下感染性休克患者术中及术后早期生命体征变化的影响。方法选择我院急诊全麻下行感染病灶去除的感染性休克患者48例,采用随机数字法随机分为两组:治疗T组和对照C组,每组各24例,T组术前行星状神经节阻滞,C组为同容量的生理盐水,对比两组患者术中生命体征、BIS值、局部脑氧饱和度(SctO 2)、术中NE用量和出入量、术后苏醒和拔管时间、术后1 d和3 d CRP、3 d和7 d的MMSE评分。对数据进行统计学处理分析。结果两组患者术前情况及术中出入量对比差异无统计学意义(P>0.05);两组术中生命体征变化、休克指数、BIS值相比差异有统计学意义(P<0.05);术中SctO 2相比差异无统计学意义(P>0.05);T组术后1 d和3 d CRP水平比C组低,差异有统计学意义;T组术后3 d和7 d的MMSE评分比C组要高,差异有统计学意义(P<0.05)。结论在感染性休克患者全麻手术中实施SGB,有利于患者术中生命体征的平稳,降低休克指数,有利于患者术后早期炎症反应及认知功能改善,本方法可在临床中选用。Objective To observe the effects of stellate ganglion block on the changes of intraoperative and early postoperative vital signs in patients with septic shock under general anesthesia.Methods A total of 48 patients with septic shock who had the infected lesions removed under emergency general anesthesia in our hospital were randomly divided into 2 groups by random number method:treatment group T and control group C,24 cases in each group,group T was treated with preoperative planetary nebulae ganglion block,group C was treated with normal saline of the same volume.The intraoperative vital signs,BIS value,local cerebral oxygen saturation(SctO 2),intraoperative NE dosage and volume in and out,postoperative recovery and extubation time,postoperative CRP 1 day and 3 day,and MMSE scores 3 day and 7 day were compared between the two groups.The data was analyzed statistically.Results There was no significant difference in preoperative conditions and intraoperative intake and outflow between 2 groups(P>0.05).There were statistically significant differences in intraoperative vital signs,shock index and BIS between the two groups(P<0.05).There was no significant difference in SctO 2 during operation(P>0.05).The postoperative 1 day and 3 d CRP levels in group T were lower than those in group C,and the differences were statistically significant(P<0.05).The MMSE score of group T at 3 days and 7 days after operation was higher than that of group C,and the difference was statistically significant(P<0.05).Conclusion The implementation of SGB during general anesthesia for patients with septic shock is beneficial to the stability of patients intraoperative vital signs,the reduction of shock index,and the improvement of patients early postoperative inflammatory response and cognitive function.Therefore,this method can be used in clinical practice.

关 键 词：星状神经节阻滞 感染性休克 BIS值 MMSE评分 

分 类 号：R459.9[医药卫生—治疗学]