亚低温联合星状神经节阻滞对脑动脉瘤患者介入术后脑功能的影响

Effect of Mild Hypothermia Combined with Stellate Ganglion Block on Brain Function of Patients with Cerebral Aneurysm After Interventional Operation

目的观察亚低温联合星状神经节阻滞对脑动脉瘤患者介入术后脑功能的影响。方法选取河南大学淮河医院2019年3月至2021年6月择期或急诊接受脑动脉瘤介入治疗的80例患者作为研究对象。根据治疗方案分为4组:A组(接受传统治疗)、B组(接受神经阻滞)、C组[接受神经阻滞联合低温(35.0±0.5)℃治疗]、D组[神经阻滞联合低温(32.0±0.5)℃治疗],各20例。比较患者手术前后经颅多普勒大脑中动脉血流速度、局部脑氧饱和度(rSO2)、血内皮素-1(ET-1)、S100β蛋白以及简易智力状态检查量表(MMSE)评分。结果与A组比较,术后B、C、D组患者大脑中动脉血流速度、ET-1和S100β降低,rSO2升高(P<0.05)。与B组比较,D组患者大脑中动脉血流速度、ET-1、S100β水平降低,MMSE评分升高(P<0.05)。结论星状神经节阻滞和其联合亚低温疗法均可减少ET-1释放,缓解脑血管痉挛,改善患者术后脑功能,其中星状神经节阻滞联合(32.0±0.5)℃亚低温疗法对于术后脑功能保护效果最为明显。

Objective To observe the effect of mild hypothermia combined with stellate ganglion block on brain function of patients with cerebral aneurysm after interventional operation.Methods From March 2019 to June 2021 in Huaihe Hospital of Henan University,80 patients who received interventional therapy for cerebral aneurysms in elective or emergency were selected as the research objects.According to the treatment plan,they were divided into four groups:group A(receiving traditional treatment),group B(receiving nerve block),group C[receiving nerve block combined with hypothermia(35.0±0.5)℃treatment]and group D[receiving nerve block combined with hypothermia(32.0±0.5)℃treatment],with 20 cases in each group.Transcranial doppler blood flow velocity of middle cerebral artery,regional cerebral oxygen saturation(rSO2),blood endothelin-1(ET-1),S100βprotein and mini-mental state examination scale(MMSE)scores were compared before and after operation.Results Compared with group A,the blood flow velocity of middle cerebral artery,ET-1 and S100βdecreased and rSO2 increased in group B,C and D after operation(P<0.05).Compared with group B,the blood flow velocity of middle cerebral artery,the levels of ET-1 and S100βdecreased,and the MMSE score increased in group D(P<0.05).Conclusion Stellate ganglion block and it combined with mild hypothermia therapy can reduce the release of ET-1,relieve cerebral vasospasm and improve postoperative brain function.Among them,stellate ganglion block combined with(32.0±0.5)℃mild hypothermia therapy has the most obvious protective effect on postoperative brain function.