摘要目的 探讨星状神经节阻滞在老年患者脊柱手术中的应用效果。方法 选取2019年6月至2021年8月江西省中西医结合医院收治的80 例脊柱手术老年患者作为研究对象，采用随机数字表法分为对照组（40 例）和观察组（40 例），两组均行全身麻醉，观察组在超声引导下行星状神经节阻滞，对照组同种方式注入等量生理盐水。比较两组术前1 d 及术后7 d 的术后认知功能障碍水平，比较两组治疗前后脑组织氧代谢相关指标变化及不良反应发生情况。结果 观察组术后7 d 的简易精神量表（MMSE）和蒙特利尔认知功能评估量表（MoCA）评分均高于对照组，差异有统计学意义（P＜0.05）；观察组术后7 d 的脑组织二氧化碳分压（PtiCO2）低于对照组，脑组织氧分压（PtiO2）及颈静脉血氧饱和度[Sjv（O2）]高于对照组，差异有统计学意义（P＜0.05）；两组不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论 星状神经节阻滞对老年患者脊柱手术的认知功能有改善作用，其安全性高。
Abstract：Objective To investigate the application effect of stellate ganglionic block in spinal surgery of elderly patients.Methods A total of 80 spinal surgery elderlypatients admitted to Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine from June 2019 to August 2021 were selected as the study subjects,and divided into control group(40 cases)and observation group(40 cases)by random number table method.Both groups were given general anesthesia.The observation group underwent ultrasound guided stellate ganglionic block,and the control group was injected with the same amount of normal saline in the same way.The level of postoperative cognitive dysfunction was compared between the two groups at 1 day before surgery and 7 days after surgery.The changes of brain oxygen metabolism and the incidence of adverse reactions were compared between the two groups before and after treatment.Results After 7 days of treatment,the mini-mental state examination scale(MMSE)score and the Montreal cognitive assessment scale(MoCA)score of observation group were higher than those of the control group,the differences were statistically significant(P＜0.05).After 7 days of treatment,brain tissue carbon dioxide tension(PtiCO2)of the observation group was lower than that of the control group,while brain tissue oxygen tension(PtiO2)and jugular venous oxygen saturation(Sjv[O2])were higher than those of the control group,the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Stellate ganglionic block can improve cognitive function in elderly patients undergoing spinal surgery,with high safety.
邓伦童;胡海涛;梅海翔. 星状神经节阻滞在老年患者脊柱手术中的应用效果[J]. 中国当代医药, 2022, 29(10): 119-121.
DENG Luntong; HU Haitao ;MEI Haixiang. Application effect of stellate ganglionic block in spinal surgery of elderly patients. 中国当代医药, 2022, 29(10): 119-121.
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