星状神经节阻滞对高血压脑出血患者开颅手术围术期转归的影响

Effect of stellate ganglion block on perioperative outcome of craniotomy in patients with hypertensive intracerebral hemorrhage

目的探讨星状神经节阻滞对高血压脑出血患者围术期的影响。方法选择新疆医科大学第二附属医院急诊高血压脑出血需行开颅手术的患者48例,随机分为星状神经节阻滞组(实验组)和未行星状神经节阻滞组(对照组),每组24例,2组分别在手术开始时(T0)、打开硬脑膜后30 min(T1)、术毕(T2)、转入ICU后30 min(T3)4个时点记录MAP、HR,苏醒后拔管时间、术中出现脑水肿的例数及术后一周内ICP及相关并发症出现的例数。结果实验组苏醒后拔管时间短于对照组;术中术后生命体征较对照组要平稳;术中脑水肿显著少于对照组,术后颅内压水平相对于对照组更要低且平稳,差异均有统计学意义(P<0.05)。结论星状神经节阻滞用于高血压脑出血开颅手术患者能能好的保持生命体征平稳,减少术中脑水肿及术后颅内压升高情况。

Objective To investigate the effect of stellate ganglion block on perioperative period in patients with hypertensive cerebral hemorrhage.Methods Forty-eight patients with urgent hypertensive cerebral hemorrhage who needed to undergo craniotomy in the Second Affiliated Hospital of Xinjiang Medical University were randomly divided into stellate ganglion block group(experimental group)and non-planetary ganglion block group(control group).24 cases in each group,2 groups recorded MAP at the four time points at the beginning of surgery(T0),30 minutes after opening the dura mater(T1),after surgery(T2),and 30 minutes after transfer to the ICU(T3),HR,Extubation time after recovery,the number of cases of cerebral edema during operation and the number of ICP and related complications within one week after operation.Results The extubation time of the experimental group was shorter than that of the control group.The vital signs during the operation were stable compared with the control group.The cerebral edema during the operation was significantly less than that of the control group.The differences were statistically significant(P<0.05).Conclusion Stellate ganglion block can be used in patients with hypertensive cerebral hemorrhage and craniotomy to keep the vital signs stable,reduce cerebral edema during surgery and increase intracranial pressure.