【摘要】 目的探讨超声实时引导经颈外侧区星状神经节阻滞的可行性和安全性。方法 2011年9月~2013年12月对颈源性头痛80例采用高频超声检查双侧颈外侧区,评估于第6、7颈椎横突水平,经前斜角肌路径穿刺阻滞星状神经节的危险因素。选择安全路径,实时引导穿刺和药物注射。结果 80例双侧C6、C7横突水平颈外侧入路探查。32侧穿刺路径上存在危险因素,其中甲状腺下动脉占34.4%(11/32),颈静脉占31.2%(10/32),椎动静脉占12.5%(4/32),其他动脉占21.9%(7/32)。79例完成穿刺,1例因C6、C7水平穿刺路径上均存在危险因素,放弃穿刺。79例穿刺后10 min内均出现Horner综合征。出现轻微副反应4例(5.1%),其中声音嘶哑2例、上肢麻木1例、头晕1例,均自行缓解。阻滞前79例VAS评分(8.9±0.9)分,阻滞后0.5 h VAS评分(5.7±2.1)分,与阻滞前比较明显降低(t=13.154,P=0.003);阻滞后1 d VAS评分(5.3±2.5)分,与阻滞前比较明显降低(t=12.626,P=0.002)。结论高频超声实时引导颈外侧入路星状神经节阻滞成功率高,方法安全。更多还原

【Abstract】 Objective To study the possibility and safety of ultrasound-guided stellate ganglion block( SGB) via lateral cervical approach. Methods A total of 80 patients with cervicogenic headache were examined of their lateral cervical regions with high frequency ultrasound. Ultrasound-guided SGB was performed through the anterior scalenus muscle at sixth or seventh cervical vertebral levels( C6/ C7). Dangerous structures locating along the needle path were evaluated. Results Both sides of lateral cervical approach in 80 patients were studied. Dangerous structures were found along the needle path in 10%( 32 /320) cases,34. 4%( 11 /32) of whom were due to inferior thyroid artery,31. 3%( 10 /32) were due to internal jugular vein,12. 5%( 4 /32) were due to vertebral artery / vein,and 21. 9%( 7 /32) were due to other arteries. SGB was performed in 79 patients while abandon of performance was deceided in one patient. Horner’s syndrome was found in all SGB patients in 10 minutes. Slight complication was found in 4 cases( 5. 1%),including 2 cases of hoarse,1 case of arm numb,and 1 case of dizziness. These symptoms were spontaneously subsided. The VAS scores were( 8. 9 ± 0. 9) points before the block and( 5. 7 ± 2. 1) points at 0. 5 h after the block( t = 13. 154,P = 0. 003) and( 5. 3 ± 2. 5) points on the second day after the block( t = 12. 626,P = 0. 002). Conclusion Ultrasound-guided SGB through lateral cervical approach is a safe method with high success rate.更多还原