三种神经阻滞方法治疗顽固性呃逆疗效对比观察

Comparison the efficacy of three nerve block treating continued hiccup

目的:比较星状神经节,膈神经,第4颈椎椎间孔3种神经阻滞方法治疗顽固性呃逆的临床疗效。方法:对中西医结合治疗无效、持续4 8h顽固性呃逆患者12 0例随机分为A、B、C3组:A组:星状神经节阻滞(n=4 0 ) ,B组:膈神经阻滞(n=4 0 ) ,C组:第4颈椎椎间孔阻滞(n=4 0 ) ,3组病例全部采用1%利多卡因,0 .375 %布比卡因合剂10 ml,于注药后10 min按优、良、好转、无效四级评价治疗效果。结果:星状神经节阻滞优良率90 % ,膈神经阻滞优良率80 % ,第4颈椎椎间孔阻滞优良率75 % ,总有效率A与C组比较有显著性差异(P<0 .0 5 )。结论:3种神经阻滞方法均能完全有效地阻滞膈神经、迷走神经、颈交感神经,降低膈神经的应激性,中断和减轻呃逆发作。星状神经节阻滞安全可靠,效果更优良。

Objective:To compare the effect of treating continued hiccup by three block methods(stellate ganglion,diaphragm nerve,the fourth cervical vertebra hole).Method:120 patients with continued hiccup were divided into three groups randomly: group of stellate ganglion block (group A,n=40 ) group of diaphragm nerve block (group B,n=40) and group of the fourth cervical vertebra hole block (group C,n=40).All patients were blocked by 1% lidocaine and 0.375% Bupivcaine 10 ml.Effects were observed 10 mins later.Results:The good rates of group A,B,C were 85%,76%,62%,respectively.Significant differences was found between group A and group C(P<0.05,respectively).Conclusion:All three nerve block could block phrenic nerve vagus nerve,and cervical sympathetic nerve.They could also reduce stress of phrenic nerve,and stop hiccup occurring.Stellate ganglion block treating continued hicuup was better and safer.