星状神经节阻滞治疗重症头痛的临床效果及其与双颈总、双椎动脉血流变化的相关性

CLINCAL EFFECT OF STELLATE GANGLIONIC BLOCK ON PATIENTS SUFFERED FROM SEVERE HEADACHE AND ITS CORRELATION WITH CHANGES IN THE PATIENTS'''' CAROTID AND VERTEBRAL ARTERIES HEMODYNAMICS

摘要:

目的探讨重症头痛双颈总动脉、双椎动脉血流动力学特征及其与星状神经节阻滞(SGB)效果的相关性.方法选择本院门诊重症头痛病人30例为治疗(T)组,和非头痛病人30例做对照(C)组;以DIASONICS,SPEC-TRA彩色多普勒超声诊断仪,测量两组SGB前,及T组阻滞后5分钟(T5)的双侧颈总动脉和双侧椎动脉血流动力学参数血流量(FLOW),阻力指数(RI),峰值流速(PKV)),时间平均流速(TAV)等.T组SGB前后临床疼痛程度评定采用五点口述分级(VRS-5)记录.结果T组于阻滞后约一分钟均有阻滞侧瞳孔缩小;阻滞前RI,PKV,VRS-5均显著高于对照组(P＜0.01);阻滞后RI,PKV恢复正常范围,VRS-5均有显著下降P＜0.01).结论SGB治疗重症头痛效果肯定.本组重症头疼病人有颅脑血管张力异常变化,提示SGB可能通过平衡植物性神经,双向调节所支配区域血管张力,使头痛缓解.

Abstract:

Aim: To explore the carotid and verterbral arteries hemodynamic feature of patients with intensive headache and its correlation with effect of Stellate Ganglionic Block (SGB). Methods: Patients were divided into two groups: group T with severe headache receiving treatment,and group C without headache as contral. Color Doppler imaging was used to measure hemodynamic parameters, including Resistance Index(RI), Peak Value Velocity (PKV),Time Average Velocity (TAV) and Flow, in group T, C and 5 min after SGB in group T5. Results : RI and PKV were higher in T than in C; RI and PKV were returned to normol after SGB. Conclusion : Patients with intensive headache may be caused by abnormal cerebrovascular tension; Effect of SGB is related to dual regulation of the abnormal vascular tension.