超声引导下星状神经节阻滞治疗失眠症疗效和安全性评价
Efficacy and Safety Evaluation of Ultrasound Guided Stellate Ganglion Block for the Treatment of Insomnia
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摘要: 目的 观察超声引导下星状神经节阻滞治疗失眠症的疗效和安全性.方法 选取48例诊断为失眠症需行SGB治疗且无禁忌证患者,随机分为2组,超声引导下穿刺组(n=24)应用超声引导定位SGB,常规穿刺组(n=24)应用传统盲探穿刺SGB治疗.评价失眠改善情况,观察手术操作时间、霍纳征发生率、穿刺针误入血管率、气胸发生率、穿刺点疼痛率、臂丛神经阻滞和喉返神经阻滞等不良反应.结果 超声引导穿刺组治疗失眠症有效率为95.83%,常规穿刺组为83.33%,2组相比差异无统计学意义(P>0.05).超声引导穿刺组霍纳征出现率98.6%,高于常规穿刺组83.5%(P<0.05).超声引导穿刺组穿刺针误入血管(0%)、穿刺点疼痛(1.3%)、气胸发生(0%)、臂丛神经阻滞(0%)和喉返神经阻滞(0.2%)均低于常规穿刺组(P<0.05).结论超声引导定位下星状神经节阻滞治疗失眠症疗效确切可靠,比传统盲探法更安全,不良反应少,可予以推广.Abstract: Objective To evaluate the efficacy and safety of ultrasound guided stellate ganglion block for the treatment of insomnia. Methods Forty-eight patients diagnosed as insomnia accepting SGB treatment without contraindication were included and randomly divided into 2 groups, ultrasound guided puncture group(n=24)and conventional puncture group(n=24). Then we evaluated the curative effect, observed the operation time and the incidence of entering blood vessel, Horner syndrome, discomfort during operation, puncture site pain,laryngeal nerve block, brachial plexus block and local anesthetics allergy. Results The effective rate of ultrasound-guided puncture group was 95.83%, the effective rate of the conventional puncture group was 83.33%,there was a statistically significant difference between two groups(P<0.05). The occurring rate of Horner syndrome in ultrasound-guided puncture group was 98.6%,higher than that of conventional puncture group 83.5%(P<0.05). The incidence of entering blood vessel(0%), puncture site pain(1.3%), pneumothorax(0%),brachial plexus block(0%) and laryngeal nerve block were lower than that of conventional puncture group(P<0.05). Conclusion The efficacy of ultrasound-guided stellate ganglion block treatment for insomnia is reliable,and the operation is safer with less adverse reaction compared to conventional blinding puncture.
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Key words:
- Insomnia /
- Ultrasound guiding /
- Stellate ganglion block
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[1] [1]GLASS J,LANCTOT KL,HERRMANN N,et al.Sedative hypnotics in older people with insomnia:Meta-analysis of risks and benefits[J].BMJ,2005,331(7526):1169. [2]罗义竣,孙璐.星状神经节阻滞治疗失眠60例[J].临床军医杂志,2010,38(2):291-292. [3] [3]BHATIA A,FLAMER D,PENG P W.Evaluation of sono anatomy relevant to performing stellate ganglion blocks using anterior and lateral simulated approaches:An observational study[J].Can J Anaesth,2012,59((11):1040-1047. [4] 李军祥,陈朝晖,刘洋.超声技术在临床麻醉中的应用进展[J].川北医学院学报,2012,27(5):515-518. [5]石崇俭.疼痛阻滞与解剖彩色图谱[M].北京:人民卫生出版社,2006:127-129. [6]中华医学会神经病学分会睡眠障碍学组.中国成人失眠诊断与治疗指南[J].中华神经科杂志,2012,45(7):534-540. [7] 马辉,许华.超声引导下疼痛注射技术图解[M].上海:上海科学技术出版社,2016:145-147. [8]李玲,郭世锦.失眠症患者心理障碍120例临床分析[J].临床合理用药杂志,2016,9(11):102. [9]王兆军,王学燕.镇静催眠药物在慢性失眠患者中的使用情况调查[J].中国民康医学,2015,27(11):92-93. [10]张立生,刘小立.现代疼痛学[M].石家庄:河北科学技术出版杜,1999:1146. [11]李仲廉.临床疼痛治疗学[M].天津:天津科学技术出版杜,1998:241. [12]赵金红,孙聪敏.星状神经节阻滞相关并发症及护理对策[J].中国实用神经疾病杂志,2012,15(11):90-91. [13]李明,戴晓蓉,朱雁鸿,等.超声引导联合神经刺激器在上肢臂丛神经阻滞的临床研究[J].昆明医科大学学报,2014,35(12):137-140. [14] [14]YOO S D,JUNG S S,KIM H S,et al.Efficacy of ultrasonography guided stellate ganglion blockade in the stroke patients with complex regional pain syndrome[J].Ann Rehabil Med,2012,36(5):633-639. [15] [15]SIEGENTHALER A,MLEKUSCH S,SCHLIESSBACH J,et al.Ultrasound imaging to estimate risk of esophageal and vascular puncture after conventional stellate ganglion block[J].Reg Anesth Pain Med,2012,37(2):224-227. -
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