星状神经节阻滞对老年上腹部术后谵妄和脑氧代谢的影响

发布时间：2018-03-06 22:24

本文选题：星状神经节阻滞　切入点：术后谵妄　出处：《广东医学》2017年S1期 　论文类型：期刊论文

【摘要】：目的探讨星状神经节阻滞(SGB)对老年上腹部术后谵妄的影响及可能机制。方法择期行上腹部手术老年患者60例,随机分为对照组(C组)和SGB组,SGB组采用改良气管旁入路法行右侧SGB。两组使用相同的麻醉方法及麻醉药物。于右颈内静脉逆行置管后即刻(T_0)、SGB后15 min(T_1)、SGB后60 min(T_2)、术毕前60 min(T_3)及术毕(T_4)时分别在桡动脉和颈内静脉球采血,行血气分析并于术前1 d及术后1、2、3 d随访谵妄的发生(CAM法)情况。结果两组手术时间差异无统计学意义,各时点血流动力学指标均在目标范围内(P0.05);与对照组相比,SGB组T_1~T_3时颈内静脉球血氧饱和度(Sjv O_2)升高,动脉血氧含量(Ca O_2)-静脉血氧含量(Cjv O_2)和脑氧摄取率(CEO_2)降低,术后1、2、3 d CAM评分升高,术后谵妄发生率降低。结论 SGB可减少老年患者术后谵妄的发生,其机制可能与改善脑氧代谢有关。
[Abstract]:Objective to investigate the effect and possible mechanism of stellate ganglion block (SGB) on delirium after upper abdominal operation in elderly patients. Two groups were randomly divided into control group (group C) and SGB group (group B) were treated with modified paratracheal approach. The two groups were treated with the same anesthetic methods and anesthetic drugs. Immediately after retrograde placement of the right internal jugular vein, the right jugular vein was retrograde placed in the right jugular vein. Blood samples were taken from radial artery and jugular bulb at the end of operation. The incidence of delirium was analyzed 1 day before operation and 2 days after operation. Results there was no significant difference in the operation time between the two groups. Compared with the control group, the blood oxygen saturation of jugular bulb (Sjv O _ 2) increased, the arterial oxygen content (Ca) O _ 2O _ (2) and the cerebral oxygen uptake rate (CEO _ (2)) decreased in the SGB group compared with the control group. The CAM score increased and the incidence of delirium decreased on the 1st and 2nd day after operation. Conclusion SGB can reduce the incidence of postoperative delirium in elderly patients, and its mechanism may be related to the improvement of cerebral oxygen metabolism.
【作者单位】：潍坊医学院麻醉学系;中国人民解放军第一四八中心医院麻醉科;潍坊医学院附属医院麻醉科;
【分类号】：R614

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