超声引导星状神经节阻滞术对失眠病人睡眠质量及血清糖皮质激素、生长激素水平的影响

摘要

Objective: To investigate the influence of ultrasound-guided stellate ganglion block (U-SGB) on sleep quality and serum levels of glucocorticoid and growth hormone (GH) in patients with insomnia. Methods:One hundred and twenty-three patients with insomnia from neurology clinic of our hospital during the period of January 2016 to January 2017 were retrospectively analyzed. The patients were divided into two groups. The observation group (n = 62) were given the treatment of U-SGB and control group (n = 61) were given estazol-am tablets. Serum glucocorticoid and GH levels were detected by radioimmunoassay (RIA) at pre-therapy and 4 weeks post-therapy. Sleep quality and life quality were evaluated referring by pittsburgh sleep quality index (PSQI) and world health organization quality of life BREF (WHOQOL BREF) standard. Results: Before treat-ment, there was no statistically significant difference in the total PSQI scors and the WHOQOL BREF domain scores between the two groups. After the treatment, PSQI scores and WHOQOL BREF scores of the two groups were lower and higher than those at pre-therapy, respectively(P < 0.001). The above scores of observation group were superior to those of control group (P < 0.001). Before the treatment, the two groups had no statistically significant differences in serum glucocorticoid and GH levels. After treatment, glucocorticoid levels of two groups were both significantly lower than those at pre-therapy. GH levels of two groups were significantly higher than those at pre-therapy (P < 0.001). The serum glucocorticoid and GH levels in observation group were both significantly better than those in the control group (P < 0.001). During treatment, two groups had no complications of brachial plexus block and hoarseness. Conclusion: U-SGB can significantly improve sleep quality and life quality for patients with insomnia, and improve serum glucocorticoid and GH levels. It is worthy of clinical application.%目的:探讨超声引导星状神经节阻滞术 (ultrasound guided stellate ganglion block,U-SGB) 对失眠病人睡眠质量及血清糖皮质激素、生长激素 (growth hormone, GH) 水平的影响.方法:回顾性分析本院2016年1月至2017年1月期间本院神经内科门诊失眠病人123例,根据不同治疗方式将病人分为两组,观察组(n = 62) 采用U-SGB术治疗,对照组 (n = 61) 采用艾司唑仑片,采用放射免疫分析法 (Radioimmunoassay, RIA)检测治疗前与治疗4周后糖皮质激素与GH 水平.参照匹兹堡睡眠质量指数 (pittsburgh sleep quality index, PSQI)与世界卫生组织生活评定量表简表 (world health organization quality of life BREF, WHOQOL-BREF) 标准评定睡眠质量与生活质量.结果:治疗前,两组PSQI各维度及总评分、WHOQOL-BREF各领域评分比较差异无统计学意义,治疗后,两组病人的PSQI评分均显著低于治疗前,WHOQOL-BREF评分也都明显高于治疗前 (P < 0.001);其中观察组上述评分明显优于对照组,两组比较差异具有统计学意义(P < 0.001).治疗前,两组病人血清糖皮质激素、GH水平比较差异无统计学意义,治疗后,全部病人糖皮质激素明显低于治疗前,GH水平明显高于治疗前 (P < 0.001),其中观察组上述指标明显优于对照组,两组比较差异具有统计学意义(P < 0.001).两组治疗期间均未出现臂丛神经阻滞、声音嘶哑等并发症.结论:U-SGB可明显改善失眠病人睡眠质量与生活质量,改善血清糖皮质激素、GH水平,值得临床推广应用.