摘要
目的探讨超声引导下经皮穿刺星状神经节阻滞(stellate ganglion block,SGB)对神经重症胃肠功能障碍患者的影响。方法选取2024年4月至2024年11月山西省人民医院收治的神经重症胃肠功能障碍患者(急性生理学及慢性健康状况评分Ⅱ评分≥15分;符合急性胃肠损伤Ⅱ级和Ⅲ级诊断者)40例为研究对象,采用随机数表法将患者分为SGB组和对照组,每组20例。SGB组于第6颈椎水平在超声引导下行SGB操作,注入1%利多卡因10 mL;对照组在同一部位超声引导下经皮穿刺注入10 mL 0.9%氯化钠溶液,连续注射5 d,分别于入院时、治疗5 d后采集空腹静脉血,采用酶联免疫吸附测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10的浓度,同时,测量血白细胞计数、反应蛋白(CRP)等指标,并记录肠鸣音恢复时间和肛门排气时间,腹内压(IAH)、ICU住院时间。结果治疗后,SGB组IL-6、TNF-α、白细胞计数、CRP显著低于对照组,IL-10显著高于对照组,差异均有统计学意义(P<0.05。治疗后,SCG组肠鸣音恢复时间、肛门排气时间、腹内压、ICU住院时间均短于对照组,差异均有统计学意义(P<0.05)。结论超声引导下经皮穿刺SGB可减轻神经重症患者的炎症反应,降低腹内压,促进胃肠功能恢复,加快神经重症患者恢复。
Objective To explore the effect of stellate ganglion block under ultrasound guidance on patients with severe neurological gastrointestinal dysfunction.Methods Forty patients with neurocritical gastrointestinal dysfunction(Acute Physiology and Chronic Health EvaluationⅡscore≥15 points;those meeting the diagnosis of acute gastrointestinal injury gradeⅡandⅢ)admitted to Shanxi Provincial People's Hospital from April 2024 to November 2024 were selected as the research objects.The patients were divided into the stellate ganglion block(SGB)group and the control group by the random number table method,with 20 patients in each group.In the SGB group,SGB operation was performed at the level of the sixth cervical vertebra under ultrasound guidance,and 10 mL of 1%lidocaine was injected.In the control group,10 mL of 0.9%sodium chloride solution was injected by percutaneous puncture under ultrasound guidance at the same site for 5 consecutive days.Fasting venous blood was collected at admission and 5 days after treatment.The concentrations of plasma tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-10 were measured by enzyme-linked immunosorbent assay.At the same time,indicators such as white blood cell count and C-reactive protein(CRP)were measured,and the recovery time of bowel sounds,the time of anal exhaust,intra-abdominal pressure(IAH),and the length of stay in the intensive care unit(ICU)were recorded.Results In the SGB group,the levels of plasma TNF-α,IL-6,white blood cell count,and CRP decreased more significantly compared with the control group,while the level of IL-10 increased more significantly.In the SGB group,the recovery time of bowel sounds and the time of anal exhaust were earlier than those in the control group,the intra-abdominal pressure was lower,and the length of stay in the ICU was shortened.Conclusion Ultrasound-guided percutaneous stellate ganglion block(SGB)can reduce the inflammatory response in patients with severe neurological diseases,lower the intra-abdominal pressure,promote the recovery of gastrointestinal function,and accelerate the recovery of these patients.
作者
程刚
张世渊
贾禄
宋璐
郭宇宏
刘小军
李晓冬
霍宇琪
杨晓晨
李晓捷
高海燕
王晓宇
马久红
张秀峰
CHENG Gang;ZHANG Shiyuan;JIA Lu;SONG Lu;GUO Yuhong;LIU Xiaojun;LI Xiaodong;HUO Yuqi;YANG Xiaochen;LI Xiaojie;GAO Haiyan;WANG Xiaoyu;MA Jiuhong;ZHANG Xiufeng(Department of Neurosurgery,Shanxi Provincial People′s Hospital,Taiyuan,Shanxi 030012,China)
出处
《中华神经外科疾病研究杂志》
2025年第4期78-81,共4页
Chinese Journal of Neurosurgical Disease Research
关键词
神经重症
星状神经节
超声引导
胃肠功能
Severe neurological diseases
Stellate ganglion
Ultrasound-guidance
Gastrointestinal function
