星状神经节阻滞术治疗心律失常患者临床疗效分析  

Clinical efficacy analysis of stellate ganglion blockade for the treatment of patients with arrhythmia

作　　者：周海鹏 张颖 蒋再新 张东红 关绍义 马超群 王祖禄 梁明 ZHOU Hai-peng;ZHANG Ying;JIANG Zai-xin;ZHANG Dong-hong;GUAN Shao-yi;MA Chao-qun;WANG Zu-lu;LIAN Ming(partment of Cardiology,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院心血管内科,辽宁沈阳110016

出　　处：《临床军医杂志》2024年第6期564-567,共4页Clinical Journal of Medical Officers

基　　金：沈阳市关键技术攻关计划(21-172-9-11)。

摘　　要：目的探讨星状神经节阻滞术治疗心律失常的疗效。方法选取2023年6—10月北部战区总医院心血管内科收治的10例药物治疗效果欠佳的心律失常患者为研究对象,心律失常种类包括室性心动过速电风暴8例,快速心房颤动1例,频发室性早搏1例。患者接受单侧或双侧星状神经节阻滞,阻滞药物为1%利多卡因100 mg。记录患者阻滞前后抗心律失常药物使用情况、心律失常发作情况、电复律次数,随访出院及临床转归情况。结果5例(50.0%)患者单次星状神经节阻滞后心律失常发作终止,3例(30.0%)患者2次阻滞后心律失常发作终止,2例(20.0%)患者3次阻滞后心律失常发作终止。抗心律失常药物种类在星状神经节阻滞治疗后有7例(70.0%)减少,3例(30.0%)无变化。3例患者阻滞后较好的出现霍纳综合征(例1、例7、例10)。10例患者均顺利完成星状神经节阻滞术,无并发症出现。电风暴患者中,3例持续48 h未再发作室性心律失常行植入型心律转复除颤器植入术后出院;1例行永久起搏器后出院;3例患者至少24 h无室性心动过速发作后出院药物治疗;1例因心脏骤停死亡。频发室性早搏患者1例,病情平稳后出院。快速心房颤动伴血流动力学障碍患者1例,病情平稳后出院,出院后10 d因心力衰竭死亡。结论对于药物治疗无效的室性心动过速电风暴、快速心房颤动、频发室性早搏,星状神经节阻滞术是一种安全有效的治疗方法。Objective To investigate the effect of stellate ganglion block in the treatment of arrhythmia.Methods Ten patients with arrhythmias with poor drug treatment effect admitted to the Department of Cardiology of General Hospital of Northern Theater Command from June to October 2023 were selected as the study objects.The types of arrhythmias included 8 cases of ventricular tachycardia electrical storm,1 case of rapid atrial fibrillation,and 1 case of frequent premature ventricular beat.The patient received unilateral or bilateral stellar ganglion block with 1%lidocaine 100 mg.The use of antiarrhythmic drugs,the occurrence of arrhythmia,the frequency of electrocardioversion before and after block were recorded,and the follow-up discharge and clinical outcome were also recorded.Results Five patients(50.0%)had the arrhythmia terminated after a single stalliform ganglion block,three patients(30.0%)had the arrhythmia terminated after two blocks,and two patients(20.0%)had the arrhythmia terminated after three blocks.The types of antiarrhythmic drugs decreased in 7 cases(70.0%)and did not change in 3 cases(30.0%).Horner syndrome appeared in 3 patients after block(case 1,case 7,case 10).All the 10 patients successfully completed stellate ganglion block without complications.Three patients were discharged after mplantable cardioverter-defibrillator implantation for 48 hours without recurrence of ventricular arrhythmia,one patient was discharged after permanent pacemaker,three patients were discharged after at least 24 hours without ventricular tachycardia and one patient died due to cardiac arrest.One patient with frequent ventricular premature beat was discharged after stable condition.One patient with rapid atrial fibrillation with hemodynamic disturbance was discharged after stable condition,and died of heart failure 10 days after discharge.Conclusion Stele ganglion block is a safe and effective treatment for patients with ventricular tachycardia,rapid atrial fibrillation and frequent premature ventricular beats that do not

关 键 词：室性心动过速 心房颤动 室性早搏 星状神经节阻滞 交感神经 

分 类 号：R541.7[医药卫生—心血管疾病]