星状神经节阻滞对心率变异性影响的实验研究

目的：探讨在家兔清醒状态下，以第7颈椎横突为标志，经皮行星状神经节阻滞的可行性和有效性．及其对心率变异性的影响。方法：健康新西兰大耳白兔16只被随机均分为左侧星状神经节阻滞组（LSGB组）、右侧星状神经节阻滞组（RSGB组）。白兔均在清醒状态下四肢固定，仰卧于动物手术台，胸前及四肢连接十二导动态心电图分析系统，稳定30min后，以第七颈椎横突为骨性标志，垂直进针，给予0．5％布比卡因1ml，行星状神经节阻滞。观察眼睑下垂程度、耳廓温度、心率变异性指标24h正常RR间期标准差（SDNN）、低频功能（LF）、高频功能（HF）、LF／HF]。另取9只家兔同法向星状神经节处推注亚甲蓝溶液后暴露星状神经节，以其是否蓝染判断注射阻滞部位的精确程度。结果：两组动物均完成星状神经节阻滞操作，术后即刻及饲养1周均未发现并发症。阻滞10min后两组动物阻滞侧均出现上睑下垂和眼裂变小。与对侧及阻滞前相比．阻滞侧耳廓温度明显升高（P〈0．05）。两组动物阻滞前后心率无明显差异，LSGB组，阻滞前、后SDNN、LF、HF、LF/HF无显著差异。RSGB组．LF和HF值在阻滞后较阻滞前显著减小（P〈0．05）．但LF／HF、SDNN无明显改变。9只家兔行亚甲蓝注射后．解剖发现8只星状神经节被染色，精确程度为88．9％（8／9）。结论：以第7颈椎横突为标志，经皮行星状神经节阻滞建立动物模型的方法切实可行，眼睑、眼裂及耳廓温度是较好的阻滞成功判断指标。星状神经节阻滞对自主神经功能有调节作用，可能就是其阻滞治疗各种疾病的作用机制之一。

Percutaneous technique for experimental stellate ganglion block in the rabbits and the influence on the heart rate variability

Objective： To investigate the practicality and effective of the percutaneous technique for stellate ganglion block （SGB） in the conscious rabbits and the influence on heart rate variability. Methods： Healthy new Zealand rabbits were randomly divided into two groups： LSGB group （n=8） underwent left side SGB, RSGB group （n=8） underwent right side SGB both using 0.25% bupivacaine. The technique of SGB was an percutaneous approach in the conscious rabbits and uses the C7 spinous process as a land mark. Ipsilateral eyelid droop, the temperature of ears, heart rate and heart rate variability were observed before and 60min after the SGB. In 9 additional rabbits, the accuracy of SGB was evaluated by injecting methylene blue to stain the stellate ganglion. Results： The eyelid droop can be observed and the temperature of the ipsilateral ears rose up after SGB in all the rabbits after 10min of SGB by bupivacaine. There was no significant difference on SDNN, LF, HF, LF/HF in LSGB group after the SGB, but LF and HF value decreased after SGB in RSGB group and with no significant change in LF/HF, SDNN. At autopsy, 8 of 9 stellate ganglion were stained by methylene blue injection. Conclusion： Percutaneous technique of SGB is a reliable technique that can be used for further studies. SGB can regulate autonomic nervous system, which may be the one of the mechanisms of its treatment.