摘要
目的通过对不同病种的临床治疗,探讨采用硬膜外阻滞治疗的适应证。方法于拟治疗疾病所涉及的脏器的相应交感神经节段,行硬膜外间隙穿刺并留置硬膜外导管5-7cm,注入低浓度局麻药0.5%利多卡因或0.2%罗哌卡因5ml,以阻滞相应脏器的交感神经节前纤维。根据不同病情调整用药剂量、每日注药次数及治疗持续时间,以临床症状和体征的改善作为判定标准。结果采用本法治疗的疾病有冠心病心绞痛、心肌梗塞、心力衰竭、心律失常、扩张型心肌病、冠心病围术期心脏保护及甲状腺机能亢进、哮喘持续状态等均获得良好的治疗效果。结论硬膜外交感神经阻滞治疗缺血性心脏病、扩张型心肌病、交感神经痛等具有稳定的临床效果。
Objective To research the indications of epidural sympathetic block in different kind of diseases. Methods Insert epidural catheter 5-7cm into epidural space to block sympathetic preganglion fibers of special organ with lower concentration of local anesthetic 5ml (0.5% lidocaine or 0.2% ropivacaine). The dosages, the periods of injection and the durations of therapy were depended on different disease. Epidural sympathetic block was used in patients with angina pectoris of coronary heart disease (CHD), myocardial infarction, arrhythmias of CHD, card-iectasis, perioperative protection of heart diseases, hyperthyroidism, patients with sympathetic chain syndrome, and status asthmaticus. Results Thoracic epidural sympathetic blockade (TESB) can relieve the pain of angina pectoris immediately, inhibit cardiac sympathetic function, reduce ventricular ectopy, enlarge coronary artery, decrease myocardial ischemic injury and infarct size. Conclusion Epidural sympathetic block have significant effects on ischemic heart disease, cardiectasis and sympathetic pain.
出处
《实用疼痛学杂志》
2005年第1期5-13,共9页
Pain Clinic Journal
关键词
硬膜外交感神经阻滞
适应证
适应证
冠心病
Sympathetic nervous system
Block
Epidural
Indication
Coronary heart disease
