连续星状神经节阻滞对颅内动脉瘤介入术后脑血管痉挛预防及对血浆褪黑素、内皮素-1的影响  

Effect of the continuous stellate ganglion block on the prevention of cerebral vasospasm after intracranial aneurysm intervention,and plasma levels of melatonin and endothelin-1

作　　者：苏圣贤[1] SU Sheng-xian(Department of Pain Medicine,Zhongshan People′s Hospital,Zhongshan Guangdong 528403,China)

机构地区：[1]广东省中山市人民医院疼痛医学科,528403

出　　处：《蚌埠医学院学报》2023年第2期214-216,221,共4页Journal of Bengbu Medical College

摘　　要：目的:研究连续星状神经节阻滞(SGB)对颅内动脉瘤介入术脑血管痉挛预防及对血浆褪黑素(MT)、内皮素-1(ET-1)水平的影响。方法:选择80例颅内动脉瘤介入术病人作为研究对象,按随机数字表法均分为观察组和对照组,对照组采取全身麻醉,观察组在对照组的基础上采取连续SGB。比较2组的大脑前动脉平均血流速度(ACA-Vm)、大脑前动脉搏动指数(ACA-PI)、大脑中动脉平均血流速度(MCA-Vm)、大脑中动脉搏动指数(MCA-PI)、大脑后动脉平均血流速度(PCA-Vm)、大脑后动脉搏动指数(PCA-PI),MT、ET-1水平,术后24 h并发症。结果:对照组治疗后的ACA-Vm、ACA-PI、MCA-Vm、MCA-PI、PCA-Vm、PCA-PI均显著高于观察组(P<0.05~P<0.01)。对照组治疗后的MT显著低于观察组,ET-1显著高于观察组(P<0.05)。术后24 h,对照组并发症发生率22.50%,显著高于观察组并发症发生率7.50%(P<0.05)。结论:连续SGB可有效稳定颅内动脉瘤介入术后的脑血流,促进MT的分泌与合成,抑制ET-1增长,从而降低脑血管痉挛等并发症发生率。Objective:To investigate the effects of continuous stellate ganglion block(SGB)on the prevention of cerebral vasospasm during intracranial aneurysm intervention,and levels of plasma melatonin(MT)and endothelin-1(ET-1).Methods:Eighty patients treated with intracranial aneurysm intervention were randomly divided into the observation group and control group according to the random number table method.The control group was treated with general anesthesia,and the observation group was additionally treated with continuous SGB on the basis of the control group.The anterior cerebral artery average blood flow velocity(ACA-Vm),anterior cerebral artery pulse index(ACA-PI),middle cerebral artery average blood velocity(MCA-Vm),middle cerebral artery pulsation index(MCA-PI),MT and ET-1 levels and postoperative 24 h complications were compared between two groups.Results:The ACA-Vm,ACA-PI,MCA-Vm,MCA-PI,PCA-Vm and PCA-PI in control group were significantly higher than those in observation group after treatment(P<0.05 to P<0.01).After treatment,the levels of MT and ET-1 in control group were significantly lower and higher than those in observation group(P<0.05).After 24 h of operation,the incidence rate of complication in control group(22.50%)was significantly higher than that in observation group(7.50%)(P<0.05).Conclusions:The continuous SGB can effectively stabilize the cerebral blood flow after intracranial aneurysm intervention,promote the secretion and synthesis of MT,and inhibit the increasing of ET-1 level,so as to reduce the incidence rate of complications such as cerebral vasospasm.

关 键 词：星状神经节阻滞 颅内动脉瘤介入术 脑血管痉挛 褪黑素 内皮素-1 

分 类 号：R651.12[医药卫生—外科学]