超声引导下星状神经节阻滞对交感型颈椎病临床效果研究

Effect of ultrasound-guided stellate ganglion block on sympathetic symptoms in patients with sympathetic cervical spondylosis

摘要:

[摘要] 目的 探讨超声引导下星状神经节阻滞治疗交感型颈椎病的有效性与安全性。方法 根据随机数字表法将我院2017年1月-2018年1月收治的40例交感型颈椎病患者分为对照组与观察组，各20例，全部患者均接受星状神经节阻滞治疗，对照组为盲穿下阻滞，观察组则在超声引导下实施阻滞。分别于治疗后30min、1周、2周，使用视觉模拟评分法（VAS）评价患者疼痛感变化情况；治疗后3个月，评价治疗效果；分别于入院时、治疗后1个月、治疗后3个月，对比两组患者交感神经症状改善情况、脊髓神经功能变化情况及生活质量改善情况，并记录患者并发症发生情况。结果 两组患者疗效比较，差异无统计学意义（P＞0.05）；两组治疗后30min、1周、2周的VAS评分均呈下降趋势，两组组间、组间·时点比较，差异无统计学意义（P＞0.05）；两组治疗后1个月、3个月的交感神经症状评分均呈下降趋势，脊髓神经功能评分及生活质量评分均呈上升趋势，两组组间、组间·时点比较，差异无统计学意义（P＞0.05）；观察组术后并发症发生率低于对照组，差异有统计学意义（P＜0.05）。结论 超声引导与盲穿星状神经节阻滞治疗交感型颈椎病效果均理想，患者交感神经症状均明显改善，脊髓神经功能均有所提升，生活质量均显著提高，但超声引导下阻滞药物使用剂量少，患者术后并发症发生率低，治疗安全性高。

Abstract:

[Abstract] Objective To investigate the effectiveness and safety of ultrasound-guided stellate ganglion block in treatment of sympathetic cervical spondylosis. Methods 40 patients with sympathetic cervical spondylosis in the hospital from January 2017 to January 2018 were divided into control group and observation group by random number table, with 20 cases in each group. All the patients were treated with stellate ganglion block, control group was given blind block, while observation group was given ultrasound-guided block. After treatment for 30min, 1 week, 2 weeks, the changes of pain in the patients were evaluated by visual analogue scale (VAS); After treatment for 3 months, the curative effects were evaluated; The changes of sympathetic symptoms, spinal cord nerve function, living quality between the two groups on admission, after treatment for 1 month and 3 months were compared, and the complications of patients were recorded. Results There was no statistical difference in the efficacy between the two groups (P>0.05); After treatment for 30min, 1 week, 2 weeks, the VAS scores of two groups showed the decreased trend, and there was no statistical difference between the two groups among groups, groups and time points (P>0.05); After treatment for 1 month and 3 months, the scores of sympathetic symptoms in the two groups showed the decreased trend, the scores of spinal cord nerve function and living quality showed the increased trend, and there was no statistical difference between the two groups among groups, groups and time points (P>0.05); The incidence of postoperative complications in observation group was lower than that in control group (P<0.05). Conclusion Ultrasound-guided and blind stellate ganglion block in treatment of sympathetic cervical spondylosis are effective, they can improve sympathetic symptoms, promote spinal cord nerve function, and increase living quality. But ultrasound-guided block has better effects than blind block, it can decrease the dose of blocking drugs, achieve the lower incidence of postoperative complications and have higher treatment safety.