[1]丁童庆,李元海,刘同昊,等.超声引导下右侧星状神经节阻滞对急性颅脑外伤伴神经源性心脏病患者术后转归的研究[J].医学信息,2024,37(03):121-124.[doi:10.3969/j.issn.1006-1959.2024.03.024]
　DING Tong-qing,LI Yuan-hai,LIU Tong-hao,et al.Study on Postoperative Outcome of Ultrasound-guided Right Stellate Ganglion Block in Patients with Acute Craniocerebral Trauma and Neurogenic Heart Disease[J].Journal of Medical Information,2024,37(03):121-124.[doi:10.3969/j.issn.1006-1959.2024.03.024]
点击复制

超声引导下右侧星状神经节阻滞对急性颅脑外伤伴神经源性心脏病患者术后转归的研究()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年03期
页码:
121-124
栏目:
论著
出版日期:
2024-02-01

文章信息/Info

Title:
Study on Postoperative Outcome of Ultrasound-guided Right Stellate Ganglion Block in Patients with Acute Craniocerebral Trauma and Neurogenic Heart Disease
文章编号:
1006-1959（2024）03-0121-04
作者:
丁童庆; 李元海; 刘同昊; 等
（安徽医科大学附属巢湖医院麻醉科，安徽 巢湖 238000）
Author(s):
DING Tong-qing; LI Yuan-hai; LIU Tong-hao; et al.
(Chaohu Hospital of Anhui Medical University,Chaohu 238000,Anhui,China)
关键词:
星状神经节阻滞; 急性颅脑外伤; 神经源性心脏病; 脑心综合征
Keywords:
Stellate ganglion block; Acute craniocerebral trauma; Neurogenic cardiomyopathy; Cerebral heart syndrome
分类号:
R614.4；R651.1+5；R541
DOI:
10.3969/j.issn.1006-1959.2024.03.024
文献标志码:
A
摘要:
的 探讨对于急性颅脑外伤并发神经源性心脏病患者，在急诊手术中应用右侧星状神经节阻滞（RSGB），能否有助于患者术后心肌损伤的转归。方法 选取2022年6月-2023年6月入我院接受急诊手术的急性颅脑外伤并发神经源性心脏病患者122例，按照随机数字表法分为常规组（n=61）和RSGB组（n=61）。常规组按照一般全身麻醉进行，RSGB组在常规麻醉的基础上加用RSGB辅助麻醉，术后两组均按照脑血管疾病临床指南治疗。比较两组在术前1 h，术后6 h及术后7天的血清肌酸激酶（CK）、肌酸激酶同工酶（CM-MB）、B型钠尿肽（BNP）、心肌肌钙蛋白T（CTNT），以及NCM的发生时间和缓解时间。结果 两组CK、CM-MB、BNP、CTNT均为先升高后降低，RSGB组CK、CM-MB、BNP、CTNT均低于常规组，差异有统计学意义（P＜0.05）；两组急性颅脑外伤后BHS发生时间比较，差异无统计学意义（P＞0.05）；RSGB组的NCM比常规组的缓解时间短，差异有统计学意义（P＜0.05）。结论 在急性颅脑外伤并发神经源性心脏病患者手术麻醉中使用RSGB可一定程度缓解患者心肌损伤，可有效改善患者的短期预后。
Abstract:
Objective To investigate whether the application of right stellate ganglion block (RSGB) in emergency surgery can contribute to the outcome of postoperative myocardial injury in patients with acute craniocerebral trauma and neurogenic heart disease.Methods A total of 122 patients with acute craniocerebral trauma and neurogenic heart disease who underwent emergency surgery in our hospital from June 2022 to June 2023 were selected and divided into conventional group (n=61) and RSGB group (n=61) according to the random number table method. The conventional group was treated with general general anesthesia, and the RSGB group was treated with RSGB assisted anesthesia on the basis of conventional anesthesia. After operation, both groups were treated according to the clinical guidelines of cerebrovascular disease. The serum creatine kinase (CK), creatine kinase isoenzyme (CM-MB), B-type natriuretic peptide (BNP), cardiac troponin T (CTNT) at 1 h before operation, 6 h after operation and 7 days after operation, the occurrence time and remission time of NCM were compared between the two groups.Results The levels of CK, CM-MB, BNP and CTNT in the two groups increased first and then decreased. The levels of CK, CM-MB, BNP and CTNT in the RSGB group were lower than those in the conventional group, and the differences were statistically significant (P<0.05). The NCM of the RSGB group was shorter than that of the conventional group, and the difference was statistically significant (P<0.05).Conclusion RSGB in surgical anesthesia for patients with acute craniocerebral trauma and neurogenic heart disease can alleviate myocardial injury to a certain extent and effectively improve the short-term prognosis of patients.

参考文献/References:

[1]Gopinath R,Ayya SS.Neurogenic stress cardiomyopathy:What do we need to know [J].Ann Card Anaesth,2018,21(3):228-234.[2]Chen Z,Venkat P,Seyfried D,et al.Brain-Heart Interaction:Cardiac Complications After Stroke [J].Circ Res,2017,121(4):451-468.[3]Mazzeo AT,Micalizzi A,Mascia L,et al.Brain-heart crosstalk:the many faces of stress-related cardiomyopathy syndromes in anaesthesia and intensive care [J].Br J Anaesth,2014,112(5):803-815.[4]Ganesh A,Qadri YJ,Boortz-Marx RL,et al.Stellate Ganglion Blockade:an Intervention for the Management of Ventricular Arrhythmias [J].Curr Hypertens Rep,2020,22(12):100.[5]Wen S,Chen L,Wang TH,et al.The efficacy of ultrasound-guided stellate ganglion block in alleviating postoperative pain and ventricular arrhythmias and its application prospects [J].Neurol Sci,2021,42(8):3121-3133.[6]Samagh N,Panda NB,Gupta V,et al.Impact of Stellate Ganglion Block in the Management of Cerebral Vasospasm:A Prospective Interventional Study [J].Neurol India,2022,70(1):289-295.[7]Powers WJ,Rabinstein AA,Ackerson T,et al.Guidelines for the Early Management of Patients With Acute Ischemic Stroke:2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke:A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [J].Stroke,2019,50(12):e344-e418.[8]Kilbourn KJ,Ching G,Silverman DI,et al.Clinical outcomes after neurogenic stress induced cardiomyopathy in aneurysmal sub-arachnoid hemorrhage:a prospective cohort study [J].Clin Neurol Neurosurg,2015,128:4-9.[9]Akashi YJ,Nef HM,M?觟llmann H,et al.Stress cardiomyopathy [J].Annu Rev Med,2010,61:271-286.[10]Lee VH,Oh JK,Mulvagh SL,et al.Mechanisms in neurogenic stress cardiomyopathy after aneurysmal subarachnoid hemorrhage [J].Neurocrit Care,2006,5(3):243-249.[11]Moussouttas M,Mearns E,Walters A,et al.Plasma Catecholamine Profile of Subarachnoid Hemorrhage Patients with Neurogenic Cardiomyopathy [J].Cerebrovasc Dis Extra,2015,5(2):57-67.[12]Ziaka M,Exadaktylos A.The Heart Is at Risk:Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy-A Review [J].J Stroke,2023,25(1):39-54.[13]Narouze S.Ultrasound-guided stellate ganglion block:safety and efficacy [J].Curr Pain Headache Rep,2014,18(6):424.[14]Deng JJ,Zhang CL,Liu DW,et al.Treatment of stellate ganglion block in diseases:Its role and application prospect[J].World J Clin Cases,2023,11(10):2160-2167.[15]Gunduz OH,Kenis-Coskun O.Ganglion blocks as a treatment of pain: current perspectives [J].J Pain Res,2017,10:2815-2826.[16]Mayo EC,Lloren NV.Effectiveness of stellate ganglion blockade on refractory ventricular arrhythmias:a systematic review protocol [J].JBI Database System Rev Implement Rep,2018,16(5):1161-1166.[17]Wittwer ED,Radosevich MA,Ritter M,et al.Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias:Implications of Ultrasound-Guided Technique and Review of the Evidence [J].J Cardiothorac Vasc Anesth,2020,34(8):2245-2252.[18]Janse MJ,Schwartz PJ,Wilms-Schopman F,et al.Effects of unilateral stellate ganglion stimulation and ablation on electrophysiologic changes induced by acute myocardial ischemia in dogs[J].Circulation,1985,72(3):585-595.[19]Przybylski A,Romanek J,Chlebus M,et al.Percutaneous stellate ganglion block as an adjunctive therapy in the treatment of incessant ventricular tachycardia [J].Kardiol Pol,2018,76(6):1018-1020.[20]Du Y,Demillard LJ,Ren J.Catecholamine-induced cardiotoxicity:A critical element in the pathophysiology of stroke-induced heart injury[J].Life Sci,2021,287:120106.[21]Cui C,Zhou XK,Zhu Y,et al.[Repeated stellate ganglion blockade for the treatment of ventricular tachycardia storm in patients with nonischemic cardiomyopathy:a new therapeutic option for patients with malignant arrhythmias][J].Chin J Cardiol,2023,51(5):521-525.

相似文献/References:

[1]夏靖宇,杨贝贝,夏晓琼,等.瑞马唑仑联合星状神经节阻滞对老年咽鼓管球囊扩张术患者术后认知功能的影响[J].医学信息,2025,38(04):97.[doi:10.3969/j.issn.1006-1959.2025.04.016]
　XIA Jingyu,YANG Beibei,XIA Xiaoqiong,et al.Effect of Remimazolam Combined with Stellate Ganglion Block on Postoperative Cognitive Function in Elderly Patients Undergoing Balloon Eustachian Tuboplasty[J].Journal of Medical Information,2025,38(03):97.[doi:10.3969/j.issn.1006-1959.2025.04.016]

更新日期/Last Update: 1900-01-01