星状神经节阻滞联合尼麦角林治疗缺血性脑卒中后吞咽障碍的临床研究  

Clinical study of stellate ganglion block combined with nicergoline in the treatment of dysphagia after ischemic stroke

作　　者：赵鹏[1] 姚玉婷 贾贤达 肖志娟[1] 郜静[1] 李燕 沈文[1] ZHAO Peng;YAO Yuting;JIA Xianda;XIAO Zhijuan;GAO Jing;LI Yan;SHEN Wen(Department of Neurology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Function,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Rehabilitation,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China)

机构地区：[1]河北北方学院附属第二医院神经内科,河北张家口075100 [2]河北北方学院附属第二医院功能科,河北张家口075100 [3]河北北方学院附属第二医院康复科,河北张家口075100

出　　处：《检验医学与临床》2025年第8期1085-1089,1095,共6页Laboratory Medicine and Clinic

基　　金：河北省张家口市2022年市级科技计划项目(2221046D)。

摘　　要：目的分析星状神经节阻滞联合尼麦角林治疗缺血性脑卒中后吞咽障碍患者的临床疗效。方法选取2022年1月至2023年1月在该院进行治疗的90例缺血性脑卒中后吞咽障碍患者作为研究对象,根据随机数字表法将其分为A、B、C组,每组30例。A组给予常规治疗;B组在A组基础上给予尼麦角林治疗;C组在B组的基础上给予星状神经节阻滞治疗。比较3组临床疗效及治疗前后洼田饮水试验、功能性吞咽障碍筛查量表(EAT10)、标准吞咽功能评价量表(SSA)、X线片吞咽造影检查(VFSS)、吞咽障碍特异性生活质量量表(SWAL-QOL)、美国国立卫生研究院卒中量表(NIHSS)评分、大脑动脉平均血流速度、血管阻力指数、最大峰值流速,以及血清神经元特异性烯醇化酶(NSE)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)水平。结果C组总有效率高于A组,差异有统计学意义(P<0.05),B组与A组总有效率比较,差异无统计学意义(P>0.05)。3组患者治疗后的SSA、洼田饮水试验、EAT10、NIHSS评分、大脑动脉血管阻力指数,以及血清NSE、ET-1水平低于治疗前,VFSS、SWAL-QOL评分及血清CGRP水平高于治疗前,最大峰值流速及平均血流速度大于治疗前,差异均有统计学意义(P<0.05)。治疗后3组SSA、洼田饮水试验、EAT10、NIHSS评分、大脑动脉血管阻力指数,以及血清NSE、ET-1水平比较结果显示,C组B组>A组,且任意两组间比较,差异均有统计学意义(P<0.05)。结论星状神经节阻滞联合尼麦角林治疗缺血性脑卒中后吞咽障碍患者,可提升血清CGRP水平,降低血清NSE、ET-1水平,促进神经修复,改善脑血流动力学,改善患者吞咽功能及临床疗效。Objective To analyze the clinical effect of stellate ganglion block combined with nicergoline in the treatment of dysphagia after ischemic stroke.Methods A total of 90 patients with dysphagia after ischemic stroke treated in this hospital from January 2022 to January 2023 were selected as the study objects and divided into groups A,B and C according to random number table method,with 30 cases in each group.Group A received conventional treatment.Group B was treated with niergoline on the basis of group A.Group C was treated with stellate ganglion block on the basis of group B.The clinical effects of 3 groups were compared,as well as the levels of water swallow test,Functional Swallowing Disorder Screening Scale(EAT10),Standard Swallowing Function Evaluation Scale(SSA),X-ray swallowing angiography(VFSS),Swallowing Disorders Specific Quality of Life Scale(SWAL-QOL),National Institutes of Health Stroke Scale(NIHSS)scores,cerebral artery average blood flow velocity,vascular resistance index,maximum peak flow velocity and serum levels of neuron-specific enolase(NSE),endothelin-1(ET-1),calcitonin gene-related peptide(CGRP)before and after treatment.Results The total effective rate of group C was higher than that of group A,and the difference was statistically significant(P<0.05),and there was no significant difference between group B and group A(P>0.05).After treatment,SSA,water swallow test,EAT10,NIHSS scores,cerebral arterial resistance index and serum NSE and ET-1 levels in 3 groups were lower than before treatment,while VFSS,SWAL-QOL scores and serum CGRP levels were higher than before treatment while the maximum peak flow velocity and average blood flow velocity were higher than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the comparison results of SSA,water swallow test,EAT10,NIHSS scores,cerebral artery vascular resistance index and serum NSE and ET-1 levels of 3 groups were compared,and the results that group C<group B<group A,and the difference between any t

关 键 词：星状神经节阻滞 尼麦角林 缺血性脑卒中 吞咽障碍 脑血流动力学 吞咽功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]