Objective To investigate the effectiveness and safety of stellate ganglion block (SGB) in the treatment of migraine and its influence on the hemodynamics of intracranial and cervical arteries.Methods Eighty patients met with the diagnostic criteria of migraine treated in Department of Pain,Sanbo Brain Hospital,Capital Medical University from June 2014 to January 2015 were selected.The pain degree was evaluated by numerical rating scale (NRS),the postoperative complications were recorded,and the efficacy was evaluated after operation for 6 months.The bilateral cervical arteries and intracranial arteries were detected by transcranial doppler sonography to record the indexes of hemodynamics.Results Compared with those before SGB,the scores of NRS after SGB were decreased,the difference was statistically significant (P ＜ 0.05).The total effective rate of SGB after 6 months was 91.25％.Compared with that before block and the opposite block side,SGB could significantly increase the diastolic flow velocities of the block side of external carotid artery and common carotid artery,decrease the pulse index,the differences were all statistically significant (P ＜ 0.05).The blood flow velocities,the changes of flow velocities and the pulse indexes of the block side and the opposite block side of the other cervical arteries and intracranial arteries had no statistically significant differences before and after SGB (P ＞ 0.05).After SGB,among 80 cases of patients,there were 6 cases (7.50％) with hoarseness (completely disappeared within 1 h),2 cases (2.50％) with transient upper limb numbness,3 cases (3.75％) with brachial plexus block,4 cases (5.00％) with puncture site pain,3 cases (3.75％) with foreign body sensation.Conclusion SGB is efficacious and safe to treat migraine.SGB can relieve the symptoms of migraine may be achieved by low-ering the vascular resistance of external carotid artery and common carotid artery,speeding up their blood flow velocity,and mildly lowering the vascular resistance of intracranial arteries.%目的 观察星状神经节阻滞(SGB)治疗偏头痛的有效性和安全性及其对头颈部动脉血流动力学的影响.方法 选取2014年6月～2015年1月首都医科大学三博脑科医院疼痛科诊治的符合偏头痛诊断标准的80例患者,采用疼痛数字评分法(NRS)评估疼痛度,并记录术后并发症,术后6个月评估疗效.对双侧颈动脉及颅内动脉行经颅多普勒超声检测并记录其血流动力学参数.结果 与SGB术前比较,术后NRS评分明显降低,差异有统计学意义(P＜0.05).SGB后6个月总有效率为91.25％.与阻滞前和阻滞对侧比较,SGB可明显升高阻滞侧颈外动脉和颈总动脉舒张期血流速度及颈外动脉平均血流速度,降低其脉动指数,差异均有统计学意义(P＜0.05).余颈部动脉及颅内动脉阻滞侧及阻滞对侧血流速度、血流速度变化量及脉动指数SGB前后差异均无统计学意义(P＞0.05).SGB后,80例患者中声音嘶哑6例(7.50％)(休息1h内完全消失),一过性上肢麻木2例(2.50％),臂丛神经阻滞3例(3.75％),穿刺部位疼痛4例(5.00％),异物感3例(3.75％).结论 SGB治疗偏头痛安全、有效;SGB缓解偏头痛症状可能主要是通过明显降低颈外动脉及颈总动脉血管阻力、加快其血流速度、轻度降低颅内动脉血管阻力而实现的.
展开▼
