星状神经节阻滞对感染性休克患者围术期脑内炎症因子及CD_(146)的作用  

The effect of stellate ganglion block on perioperative inflammatory factors and CD_(146)in patients with septic shock

作　　者：袁应川[1] 汪艳萍[1] 王龙[1] Yuan Yingchuan

机构地区：[1]新疆医科大学第二附属医院,830063

出　　处：《浙江临床医学》2023年第12期1751-1753,共3页Zhejiang Clinical Medical Journal

基　　金：新疆神经系统疾病研究重点实验室开放课题(XJDX1711-2124)。

摘　　要：目的观察星状神经节阻滞对感染性休克患者围术期脑内炎症因子及CD_(146)的影响。方法选择本院急诊行感染病灶清除术的感染性休克患者48例,采用随机数字法分为两组(T/C),每组各24例。T组术前行星状神经节阻滞,C组于星状神经节处注射同容量0.9%NaCl溶液;比较两组术中相同BIS下不同时间点的局部脑血氧饱和度(SctO_(2));术前、术后1 d和7 d的肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)、白介素-10(IL-10)、CD_(146)、乳酸(LA)浓度及术前、术后3 d和7 d的MMSE评分、APACHE-Ⅱ评分。结果两组一般情况比较,差异无统计学意义(P>0.05);T组不同时间点SctO_(2)比C组高,差异有统计学意义(P<0.05);T组炎症因子显著降低(P<0.05),抗炎因子明显升高(P<0.05),T组CD_(146)高于C组,差异有统计学意义(P<0.05);术后MMSE评分T组高于C组,APACHE-Ⅱ评分T组低于C组,差异均有统计学意义(P<0.05)。结论SGB应用于感染性休克患者,可通过减轻炎症反应及血脑屏障损伤减轻脑损伤,降低术后认知功能障碍,并促进预后。Objective To observe the effect of stellate ganglion block on perioperative intracerebral inflammatory factors and CD_(146)in patients with septic shock.Methods 48 patients with septic shock who underwent removal of infected foci in the emergency department of our hospital were selected and divided into 2 groups(T/C)using randomized numerical method,with 24 patients in each group.Group T had preoperative stellate ganglion block,while group C was injected with the same volume of saline at the stellate ganglion.Local cerebral oxygen saturation(SctO2)at different time points under the same bispectralindex(BIS)during operation in the two groups,and TNF-α,procalcitonin(PCT)in the preoperative period and at 1 d and 7 d postoperatively,C reactive protein(CRP),Interleukin-6(IL-6),Interleukin-10(IL-10),CD_(146),lactic acid(HL)concentration,mini-mental state examination(MMSE)score and acute physiology and chronic health evaluation-II(APACHE-II)score before,3 d and 7 d after operation were compared.Results The general conditions of the two groups were compared,and the difference was not statistically significant(P>0.05).SctO_(2)was higher in group T than in group C at different time points,and the difference was statistically significant(P<0.05).Inflammatory factors were significantly lower in group T(P<0.05),and anti-inflammatory factors were significantly higher in group T(P<0.05),and CD_(146)in group T was higher than in group C,with a statistically significant difference(P<0.05).The postoperative MMSE score of group T was higher than that of group C,and APACHE-II score of group T was lower than that of group C,and the difference was statistically significant in comparison(P<0.05).Conclusion Stellate ganglion block applied to patients with septic shock can reduce brain damage,decrease postoperative cognitive dysfunction,and promote prognosis by reducing inflammatory response and blood-brain barrier damage.

关 键 词：星状神经节阻滞 感染性休克 炎症因子 CD_(146) 

分 类 号：R459.7[医药卫生—急诊医学]