星状神经节阻滞对肩关节镜手术沙滩椅位脑血流动力学改变的影响研究  

Effect of stellate ganglion block on cerebral hemodynamic changes in beach chair position during arthroscopic shoulder surgery

作　　者：袁应川[1] 杜健华[1] 王龙[1] Yuan Yingchuan;Du Jianhua;Wang Long(Department of Anesthesiology,The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,Xinjiang,China)

机构地区：[1]新疆医科大学第二附属医院麻醉科,新疆乌鲁木齐830063

出　　处：《贵州医药》2024年第8期1188-1191,共4页Guizhou Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2019D01C243);乌鲁木齐市水磨沟区科学技术计划项目。

摘　　要：目的研究星状神经节阻滞对肩关节镜手术沙滩椅位脑血流动力学改变的影响。方法取择期行沙滩椅位肩关节镜手术患者40例,随机分为治疗组T组和对照组C组各20例,T组术前行超声引导下SGB,对比两组患者术中生命体征、BIS值、脑氧合饱和度(rSO_(2))、不同时段大脑中动脉血流频谱图像、术后7 d ULCA评分、MMSE评分、RBANS总分,将两组数据进行统计学处理分析。结果T组比C组患者术中生命体征变化波动较小,差异有统计学意义(P<0.05)。不同时段rSO_(2)基本保持在相同水平,差异无统计学意义(P>0.05);T组患者大脑中动脉血流流速比C组要低,但血管内径要大,根据公式得出T组患者在不同时间段血流量都要比C组同时段的多,比较差异有统计学意义(P<0.05)。两组术后7 d ULCA评分、MMSE评分、RBANS总分对比T组明显较高,差异有统计学意义(P<0.05)。结论对沙滩椅位行肩关节镜手术的患者术前实施星状神经阻滞术具有增加脑血供及脑保护作用且对患者术后关节功能恢复有良好的促进作用,有临床推广实用价值。Objective To study the effect of stellate ganglion block on cerebral hemodynamics in beach chair position in shoulder arthroscopy surgery.Methods A total of 40 patients undergoing elective shoulder arthroscopy in beach chair position were selected and randomly divided into a treatment group T group and a control group C group,20 cases in each group.The T group underwent ultrasound-guided SGB before operation,and the intraoperative vital signs of the patients in the two groups were compared.BIS value,cerebral oxygenation saturation(rSO_(2)),middle cerebral artery blood flow spectrum images in different time periods,7d postoperative ULCA score,MMSE score,RBANS total score,the two groups of data were statistically processed and analyzed.Results The changes of vital signs in group T were smaller than those in group C,and there were statistically significant differences(P<0.05).The rSO_(2)basically remained at the same level in different time periods,and there were no statistically significant differences(P>0.05).The blood flow velocity of the middle cerebral artery in the T group was lower than that in the C group,but the inner diameter of the blood vessel was larger.The blood flow in different time periods was more than that in group C at the same time period,and there were statistically significant differences(P<0.05).The ULCA score,MMSE score and total RBANS score of the two groups were significantly higher than those of the T group at 7 days after operation,and there were statistically significant differences(P<0.05).Conclusion Preoperative stellate nerve block for patients undergoing shoulder arthroscopy in beach chair position can increase cerebral blood supply and brain protection,and has a good promotion effect on postoperative joint function recovery of patients,which has practical value in clinical promotion.

关 键 词：星状神经节阻滞 肩关节镜手术 沙滩椅位 控制性降压 

分 类 号：R614[医药卫生—麻醉学]