星状神经节阻滞对围术期神经认知功能障碍影响的Meta分析  

Effect of Stellate Ganglion Block on Perioperative Neurocognitive Dysfunction:A Meta-Analysis

作　　者：万长栋 李晴 胡凯[1] 张桦 WAN Chang-dong(Department of Anesthesiology,Nanchang Hongdu Hospital of Traditional Chinese Medicine,Nanchang 330038,Jiangxi,China)

机构地区：[1]南昌市洪都中医院,江西南昌330038

出　　处：《牡丹江医科大学学报》2025年第2期111-115,105,共6页Journal of Mudanjiang Medical University

基　　金：江西省中医药管理局科技计划项目(2023A0261)。

摘　　要：目的系统评价星状神经节阻滞(stellate ganglion block,SGB)对围术期神经认知功能障碍(perioperative neurocognitive disorders,PND)的影响。方法计算机检索Pubmed、Embase、Scopus、Cochrane Library、中国知网、万方数据库、中国生物医学数据库。收集SGB对PND影响的前瞻性随机对照试验(randomized controlled trial,RCT),文献发表时间为建库至2024年3月。采用Review Manager 5.3软件进行Meta分析。结果共纳入14篇RCT研究,总共包括1245例患者,其中对照组625例,SGB组620例。与对照组比较,SGB组术后7 d内PND发生率明显降低(RR=0.31,95%CI:0.25~0.40,P<0.001),术中脑氧摄取率(CERO_(2))明显降低(SMD=-1.28,95%CI:-1.75~-0.81,P<0.001),术中颈静脉球部血氧饱和度(SjvO_(2))明显升高(SMD=1.41,95%CI:1.09~1.73,P<0.001),术中白介素-6(IL-6)浓度明显降低(SMD=-1.32,95%CI:-2.29~-0.34,P<0.001)。结论SGB可有效降低患者术后7 d内PND发生率,降低术中CERO_(2),提高术中SjvO_(2),并降低术中IL-6浓度。Objective To systematically evaluate the effect of stellate ganglion block(SGB)on perioperative neurocognitive dysfunction(PND).Methods A computerized search was conducted across PubMed,Embase,Scopus,Wanfang Database,China Biomedical Database,China National Knowledge Infrastructure,and the Cochrane Library to identify relevant literature.A prospective randomized controlled trial(RCT)was performed to investigate the impact of SGB on PND.The literature included in the review was published from the inception of the databases until March 2024.Meta-analysis was performed using Review Manager 5.3 software.Results A total of 14 RCTs involving 1245 patients were included,with 625 patients in the control group and 620 patients in the SGB group.The incidence of PND in the SGB group was significantly lower than in the control group at 7 days post-surgery(RR=0.31,95%CI:0.25,0.40,P<0.001).Additionally,intraoperative cerebral oxygen uptake rate(CERO_(2))was significantly decreased in the SGB group(SMD=-1.28,95%CI:-1.75,-0.81,P<0.001),while intraoperative blood oxygen saturation in the jugular vein bulb(SjvO_(2))significantly increased(SMD=1.41,95%CI:1.09,1.73,P<0.001).The concentration of interleukin-6(IL-6)during surgery was significantly reduced in the SGB group(SMD=-1.32,95%CI:-2.29,0.34,P<0.001).Conclusion GB effectively reduces the incidence of PND in patients within 7 days post-surgery,lowers intraoperative cerebral oxygen uptake rate,increases intraoperative jugular venous bulb oxygen saturation,and decreases intraoperative interleukin-6 concentration.

关 键 词：星状神经节阻滞 围术期神经认知功能障碍 谵妄 META分析 

分 类 号：R745[医药卫生—神经病学与精神病学]