星状神经节阻滞的机制

星状神经节阻滞能使机体的植物神经系统,内分泌系统及免疫系统等保持恒常性的功能,星状神经节阻滞现已 广泛用于疼痛性及非疼痛性疾病的治疗,取得满意疗效。     

星状神经节阻滞对兔桡骨骨折愈合的影响

星状神经节阻滞(SGB)是临床上常用的治疗疼痛的方法,也用于治疗头、颈及上肢的缺血性疾病,对促进组织修复有良好的疗效。但SGB是否能促进支配区骨折的愈合,尚待进一步研究。本研究拟评价SGB对兔桡骨骨折愈合的影响,为临床研究提供参考。     

星状神经节阻滞治疗寻常痤疮

寻常性痤疮又称青年痤疮 (青春痘 ) ,是一种毛囊与皮脂腺的慢性炎症性疾病 ,以粉刺、丘疹、脓疱、结节 ,甚至囊肿瘢痕为特征 ,多发生于青春期男女。我院近两年采用星状神经节阻滞疗法 (ｓｔｅｌｌａｔｅｇａｎｇｌｉｏｎｂｌｏｃｋ ,ＳＧＢ)治疗寻常痤疮 36例 ,取得较好的临床疗效。36例中 ,男性 17例 ,女性 19例 ,年龄 16～ 2 5岁 ,包括丘疹性痤疮和脓疱性痤疮 ,病程为 15天～ 3年 ,ＳＧＢ采用前方Ｃ6入路 ,双侧阻滞 ,左右ＳＧＢ间隔 1小时 ,每天 1次 ,1周为1疗程。每侧阻滞用药为 1%利多卡因 10ｍｌ加地塞米松2 5ｍｇ。疗效判定 :显效 ,…     

星状神经节阻滞的机制

星状神经节阻滞能使机体的植物神经系统，内分泌系统及免疫系统等保持恒常性的功能，星状神经节阻滞现已广泛用于疼痛性及非疼痛性疾病的治疗，取得满意疗效。     

星状神经节阻滞的临床观察

星状神经节阻滞(SGB)在疼痛治疗中占重要地位。现将我院从1991年至1997年7年间疼痛门诊治疗的2100例次SGB的结果总结报告如下。     

星状神经节阻滞治疗原发性三叉神经痛病人的护理

三叉神经痛是指在三叉神经分布区内反复发分的阵发性短暂剧烈疼痛,又称痛性抽搐。临床分原发性与继发性两种,病因未明的称原发性三叉神经痛,起病突然,发作时疼痛剧烈;间歇期触及"扳机点",如上下唇、颊粘膜或眼眶上缘等诱发区,常可引起疼痛,无神经系阳性体征,反复发作等特征。迄今为止仍没有一种特效的根治法。我院于1995～1997年,采用星状神经节阻滞（SGB）ie疗三叉神经痛11例,取得了较好的效果,现报告如下。1资料与方法1．回临床资料本组11例,男3例,女8例,年龄36～67岁。病程1～10年,无血液及呼吸系组病史,无普鲁卡因过…     

星状神经节阻滞对心肺转流脑损伤的影响

目的 探讨星状神经节阻滞(SGB)对心肺转流(CPB)脑损伤的影响.方法 择期二尖瓣置换术患者40例,随机分为观察组(S组)和对照组(C组),每组20例.S组麻醉诱导前行右侧SGB,C组未处理.于气管插管即刻(T1)、CPB后停止降温后5 min(T2)、CPB复温至36℃时(T3)、CPB结束后1 h(T4)测定颈静脉血氧饱和度(SjvO2),同时于各时点及CPB结束后6 h(T3)、24 h(T6)检测颈静脉血S-100蛋白及神经元特异性烯醇化酶(NSE)浓度.于术前1 d、术后第1天和第2天行简易智力量表(MMSE)测定.结果 T2时,两组SjvO2较T1时均升高(P<0.05);T3时明显降低(P<0.05);但S组波动幅度小于C组(P<0.05);T2、T3时两组MAP较T1时降低(P<0.01).T2～T5时两组S-100蛋白和NSE浓度较T1时均显著升高(P<0.05或P<0.01);但S组升高幅度小于C组(P<0.05).C组术后第1天MMSE评分低于术前1 d(P<0.05).结论 SGB可改善并稳定CPB时颈静脉血氧合,减缓血S-100蛋白及NSE水平上升,对CPB患者具有一定的脑保护作用.     

星状神经节持续阻滞二例

星状神经节阻滞是临床常用的疼痛治疗手段之一，这种阻滞是短暂、可逆的，罕有出现持续阻滞现象。近年来，我们在临床治疗过程中发现2例原因不明的星状神经节持续阻滞现象，报道如下。     

改良的星状神经节阻滞实验动物模型研究

目的：探讨颈5和颈7椎体水平穿刺入路的星状神经节阻滞效果是否相同。方法：12只雄性中国本兔,随机分为颈5（mSGB组）和颈7椎体阻滞水平组（SGB组）．分别注射0．25％布比卡因2ml后观察5．10．15,20．30．45．60分钟眼睑下垂情况。后注射0．5％亚甲蓝2ml．并处死．尸检观察记录颈交感链着色范围。结果：mSGB组及SGB组星状神经节阻滞后眼睑下垂程度无明显统计学差异．颈交感神经着色范围相同。结论：颈5和颈7水平穿刺入路星状神经节阻滞效果相同。     

星状神经节阻滞治疗创伤后应激障碍应用进展

背景 创伤后应激障碍(post-traumatic stress disorder,PTSD)是应激源刺激导致的以神经内分泌为主的多系统紊乱临床综合征,目前尚无具有确切效果的治疗方法.现常用的各种药物与心理治疗措施虽然有一定作用,但副作用多,治疗效果差.星状神经节阻滞(stellate ganglion block,SGB)治疗PTSD受到越来越多学者的关注,它起效快,治疗效果明显,持续时间长,成为一种新型的治疗PTSD的有效方法. 目的 综述SGB用于治疗PTSD的临床应用进展,为临床治疗PTSD提供一种新型的治疗思路. 内容 阐述SGB用于治疗PTSD的临床应用现状,并且对其治疗作用的可能机制进行探讨,同时为SGB可能发生的并发症提供良好的预防方案. 趋向 继药物治疗与心理治疗之后,SGB有望成为临床治疗PTSD的另一种有效而重要的方法.     

星状神经节阻滞对炎症痛兔血清白介素-8和间脑c-fos表达的影响

目的研究星状神经节阻滞（SGB）后福尔马林诱导的兔伤害行为反应、血清白介素-8（IL-8）的变化和间脑c—fos的表达,旨在探讨SGB对炎症痛的影响及其机制。方法在兔星状神经节附近置人导管,一周后,选择恢复健康者24只随机分为三组：假手术组（A组）、SGB组（B组）和对照组（C组）,每组8只。B组和C组在右前肢足底皮下注射3％福尔马林0．5ml致痛,A组同样部位注射等量生理盐水。致痛前10min,B组经导管给0．25％布比卡因0．5ml,A和c组给等量生理盐水。致痛前10min（T0）、致痛后10（T1）、60（T2）和120min（T3）取静脉血,放免法测血清IL-8浓度。致痛2h,灌注固定,取致痛局部组织和左右侧间脑。采用加权法对伤害行为反应评分,组织病理学方法观察局部炎症反应,免疫组化法检测间脑c—fos表达。结果SGB后福尔马林诱导的Ⅱ期伤害行为反应和局部炎症反应明显缓解。B组和C组T2和T3时点血清IL-8浓度较T0及T1时点显著升高（P〈0．01）;B组T2和T3时点血清IL-8浓度明显低于C组同时点（P〈0．01）。B组下丘脑c—fos表达明显少于C组（P〈0．01）,而B组与C组丘脑C—fos表达无显著性差异（P〉0．05）。结论SGB可部分抑制福尔马林诱导的血清IL-8升高和下丘脑c—fos表达,这可能与其治疗炎症痛的机制有关。     

星状神经节阻滞对急性脑梗塞患者红细胞免疫功能的影响

Objective To investigate the effects of stellate ganglion block (SGB) on erythrocyte immunity in patients with acute cerebral infarction.Methods Twenty-four patients (13 male, 11 female) who developed acute cerebral infarction for less than 3 days were randomly divided into 2 groups (n=12each): Group A receiving traditional treatment and Group B receiving traditional treatment + SGB.The patients ranged in age from 51 to 64 yr and weighed 52-71 kg. All patients received intravenous 5% glucose 25 ml plus citicoline sodium 1.0 g and sodium ozagrel injectio 250 ml daily for 10 days in addition to dehydration and effective control of complications and intracranial pressure. Group B received SGB on one side alternatively with 1% licocaine 10 mi once a day for 10 days. Fasting venous blood samples were taken in the early mornings of the day before treatment (baseline, T1 ) and the 1st, 5th and 10th day of treatment (T2-4) for determination of the plasma MDA concentration and SOD activity, erythrocyte C3b receptor rosette rate (RBC-C3bRR) and RBC immune complex rosette rate (RBC-ICR) and Ne+-K+-ATPase activity in erythrocyte membrane.Results The plasma MDA concentration and RBC-ICR were significantly decreased during treatment es compared with the baselines at T1 in both groups (P＜0.05 or 0.01), but were significantly lower in Group B than in Group A (P＜0.05 or 0.01 ).The activities of plasma SOD and Na+ -K+ -ATPase in erythrocyte membrane and RBC-C3bRR were significantly increased during treatment as compared with the baselines at T1 and were significantly higher in Group B than in Group A.Conclusion SGB combined with traditional treatment can increase the activities of plasma SOD and Na+ -K+ -ATPase in erythrocyte membrane, inhibit production of oxygen free radicals and enhance RBC immune function in patients with acute cerebral infarction.     

星状神经节阻滞对兔血浆去甲肾上腺素浓度的影响

目的观察星状神经节阻滞(SGB)对兔血浆去甲肾上腺素(NE)浓度的影响,探讨其治疗疼痛的可能机制.方法14只日本大耳白兔在严格无菌操作下暴露右侧星状神经节,置入并固定硬膜外导管,使其一端开口位于星状神经节附近,另一端自颈背部穿出.手术1w后利用福尔马林皮下注射法建立急性疼痛模型,随机分为对照组(A组)和SGB组(B组),每组7只.致痛60min后,B组经导管注入0.25%布比卡因(Bu)0.5ml,A组用等量的生理盐水(NS).观察致痛前10min(T0)、致痛后10min(T1)、30min(T2)、50min(T3)和应用Bu或NS后10min(T4)、30min(T5)、50min(T6)时血浆NE浓度的变化.结果致痛前两组血浆NE无差别(P＞0.05);与致痛前相比,致痛后两组NE均升高,且在T1时达高峰,在T2、T3时略有下降(P＜0.01);两组间血浆NE无明显差别(P＞0.05).与用NS前相比,用NS后A组血浆NE无统计学差异(P＞0.05);与用Bu前相比,用Bu后B组血浆NE明显下降(P＜0.05).结论星状神经节阻滞降低血浆NE浓度,NE降低可能是其治疗疼痛性疾病的机制之一.     

星状神经节阻滞对术后认知功能障碍的影响

背景术后认知功能障碍(postoperative cognitive dysfunction,POCD)的发生率已日趋升高.近年来,针对POCD已展开了许多研究,发现星状神经节阻滞(stellate ganglion block,SGB)对POCD有重要作用.目的综述SGB对POCD的影响,旨在为临床上研究POCD的防治提供可能的理论依据.内容SGB是临床较常用的一种阻滞技术,其治疗范围越来越广泛,治疗效果也越来越确切,不仅应用于疼痛性疾病的治疗,也日益广泛地用于神经性、内分泌性及免疫障碍性等非疼痛疾病的治疗,并取得相当显著的疗效,研究发现它对POCD有重要作用. 趋向尽管至今POCD的病因和发病机制仍不清楚,但SGB在防治老年患者POCD方面有较大的研究空间.     

星状神经节阻滞对福尔马林致痛兔脊髓P物质含量的影响

目的：观察星状神经节阻滞（SGB）对福尔马林致痛兔脊髓P物质（SP）含量的影响，探讨其治疗疼痛的可能机制。方法：健康成年日本大耳白兔在无菌操作下暴露右侧星状神经节，置入并固定硬膜外导管，命名其一端开口位于星状神经节附近，另一端自颈背部穿出，置管1周后，选择恢复健康者19只随机分为三组：假手术组（A组）5例，SGB组（B组）和对照组（C组）各7例，A组直接麻醉后灌注固定取脊髓颈段6－8（C6－8）和胸段6－8（T6－8），B组和C组用福尔马林皮下注射法建立急性疼痛模型，致痛1h后B组经导管注入0．25％布比卡因0．51ml,C组用等量生理盐水，观察1h后，同A组一样灌注固定取脊髓，用免疫组织化学检测脊髓SP含量的变化。结果：SP免疫阳性反应物集中分布在脊髓背角I，II层，B组和C组脊髓颈段SP的光密度（OD）值与A组相比均降低（P＜0．05，P＜0．01），B组脊髓颈段SP的OD值较C组显著升高（P＜0．05），三组间脊髓胸段内SP的OD值无明显差别（P＞0．05），结论：上肢皮下注射福尔马林可引起兔脊髓颈段SP含量降低，星状神经节阻滞可部分志这种现象，使SP含量升高，SP含量升高可能是其治疗疼痛性疾病的脊髓机制之一。     

Quinine overdose Prevention of visual damage by stellate ganglion block

A case of quinine poisoning is described. Stellate ganglion block was performed immediately on the basis of the clinical history of visual disturbance without waiting for physical signs to develop. There was no residual field defect despite the presence of toxic levels of the drug. It is suggested that stellate ganglion block may prevent development of visual field defects.     

Assessment of diaphragm function after stellate ganglion block using magnetic stimulation

Stellate ganglion block is a procedure frequently used for the management of patients with chronic sympathetically mediated pain affecting the arm, neck or head. We studied the effect of stellate ganglion block on ipsilateral phrenic nerve function, and hence diaphragmatic strength, in 11 adult patients with chronic sympathetically mediated pain. Pre- and post-block forced vital capacity (FVC) measurements were recorded using a pneumotachograph and a Magstim nerve stimulator was used to generate pre- and post-block twitch mouth pressures (P(TWM)). This device can be used to stimulate the phrenic nerves and hence the diaphragm. The resulting change in airway pressure was measured at the mouth and has previously been shown to reflect diaphragm strength. There was no statistically significant difference in FVC or P(TWM) pre- or post stellate ganglion block. In conclusion, a stellate ganglion block has no adverse effect on ipsilateral phrenic nerve function or diaphragm strength in healthy adult patients.     

The neck crease as a landmark of Chassaignac's tubercle in stellate ganglion block: anatomical and radiological evaluation

BACKGROUND: Stellate ganglion block (SGB) is most commonly performed at the transverse process of the sixth cervical vertebra, the identification of which could be difficult in patients with short and wide necks. This study was conducted to evaluate whether the neck skin crease is a reliable indicator of the C6 level. METHODS: Forty-nine relatively obese pain clinic patients were investigated. They assumed a standard position for SGB. A radiopaque wire was placed along the neck skin crease caudad to the thyroid cartilage. Next, a radiopaque indicator was placed on the skin above the tubercle found to be most prominent by palpation. X-rays of the neck were obtained after each procedure. RESULTS: The probability that the neck crease would cross C5, C6 and C7 was 16%, 71%, and 12%, respectively. The most prominent tubercle corresponded to the C5, C6 and C7 levels in 16%, 69% and l4% of cases, respectively. CONCLUSION: The studied means to identify the C6 transverse process was found to correlate well with each other (P<0.001). Since in 30% of cases the C6 process could not be identified by any of the studied means, radiological guidance is recommended in order to ensure optimal safety and efficacy of SGB in selected cases.     

星状神经节阻滞对全脑缺血再灌注损伤家兔海马及颞叶皮质热休克蛋白70表达的影响

目的 观察星状神经节阻滞(SGB)对全脑缺血再灌注损伤家兔海马及颞叶皮质热休克蛋白70(HSP70)表达的影响,探讨SGB对全脑缺血再灌注损伤的处理效应及可能机制。方法 健康日本大耳白兔28只,随机分成四组(n=7):SGB组(E组)、生理盐水对照组(P组)、空白对照组(C组)和假手术组(S组)。采用星状神经节旁置管法制作SGB模型及六血管阻断法制作全脑缺血再灌注损伤模型。缺血10 min再灌注30 h(E、P、C组)或观察相应时间(S组)后取脑组织,使用免疫组化技术检测双侧海马CAl区及颞叶皮质HSP70的表达。结果 与P、C组比较,E组双侧海马和颞叶皮质HSP70的表达均有不同程度下降(P<0.05),且双侧之间改变无明显差异(P>0.05)。结论持续左侧SGB,可降低全脑缺血再灌注损伤家兔神经细胞HSP70的过度表达,单侧SGB的效应对于双侧脑组织损伤后的影响差异无显著性。