星状神经节阻滞对急性心肌梗死患者预后及生活自理能力和精神状态的影响

Effects of stellate ganglion block on prognosis and self-care ability and psychosis in patients with acute myocardial infarction

目的:观察星状神经节阻滞对急性心肌梗死患者的预后及生活自理能力和精神状态的影响。方法:选择36例急性心肌梗死患者,随机分为观察组和对照组。观察组患者进行星状神经节阻滞治疗,2周为1疗程。根据心肌梗死时心绞痛减轻或缓解的情况,调整或停止输入扩冠类药物。根据病情恢复情况持续2周。对照组常规内科治疗。结果:观察组患者阻滞24h后,心绞痛症状全部缓解,视觉模拟评分法(VAS)评分观察组明显优于阻滞前及同时段对照组值,而且在整个治疗过程中未再出现心前区疼痛;观察组平均动脉压(MAP)、心率与阻滞前及同时段对照组比较有不同程度的下降和减慢;血氧饱和度(SaO2)观察组明显优于阻滞前及同时段对照组值;阻滞后24h观察组血中游离脂肪酸与阻滞前及同时段对照组比较有明显的降低(t=6.49—11.38,P<0.05)。一周后对患者生活自理能力和精神状态进行评估记分,观察组明显优对照组(!2=16.32—17.26,P<0.05)。结论:星状神经节阻滞可快速有效地缓解急性心肌梗死患者严重的缺血性疼痛,改善心肌缺血的严重程度,可明显改善急性心肌梗死患者生活自理能力和精神状态。

Objective： To study effects of stellate ganglion block on prognosis and self-care ability and psychosis in patients with acute myocardial infarction（AMI）. Method： Thirty eight patients with acute myocardial infarction（AMI） were divided randomly into study group（n=18） and control group（n=18）.The patients in study group were treated with stellate ganglion block for two weeks. The patients in control group were treated with routine medicine therapy. Result：Compared with preceding block and contemporaneous control group in study group ld after block, the patients angina symptom lightened, the scores of visual anaglogue scale （VAS）, mean arterial pressure （MAP）, cardiac rhythm and arterial oxygen saturatio（SaO2） were better obviously; free fatty acids（FFA） reduced obviously（t=6.d9- 11.38,P〈0.05）. One week later, compared with control group, in study group self-care ability and psychosis such as anxiety and depression were improved （χ^2=16.32-17.26,P〈0.05）. Conclusion：Stellate ganglion block can obviously improve prognosis, self-care ability and psychosis in patients with acute myocardial infarction.