同济大学学报（医学版）2025，Vol.46Issue(5)：645-650,6.DOI:10.12289/j.issn.2097-4345.25157
超声引导下星状神经节阻滞在颅脑损伤患者阵发性交感神经功能亢进中的应用:一项回顾性队列研究
Application of ultrasound-guided stellate ganglion block in paroxysmal sympathetic hyperactivity among patients with traumatic brain injury:a retrospective cohort study
摘要
Abstract
Objective This study aims to observe the preventive effect and safety of stellate ganglion block(SGB)on paroxysmal sympathetic hyperactivity(PSH)in patients with traumatic brain injuries(TBI).Methods A retrospective cohort study was carried out in patients with TBI admitted to High Dependency Unit(HDU)from 1st September 2023 to 28th September 2024 at Shanghai Yangzhi Rehabilitation Hospital.The eligible patients were divided into an SGB group and a control group depending on whether they received ultrasound-guided SGB during hospital stay.The primary outcome measured was the incidence of PSH during hospitalization,defined by a PSH-AM score ≥ 8 points.The secondary outcomes included Glasgow coma score(GCS)score at discharge,blood pressure and heart rate before and after SGB,and the occurrence of adverse events including but not limited to nerve injury,neck hematoma,or hoarseness,etc.Multivariate regression models were employed to adjust for confounding factors,and subgroup analyses were performed to confirm the robustness of the findings.Results The study included a total of 234 patients,101 of whom had sustained TBI,48 of them underwent ultrasound-guided SGB treatment.The multivariate regression analysis revealed that patients undergoing SGB experienced a significantly lower incidence of PSH than those who did not receive SGB treatment during hospitalization(P＜0.05).Additionally,systolic blood pressure and heart rate significantly decreased following SGB treatment,while diastolic blood pressure remained unchanged.No adverse events,including nerve injury,neck hematoma,or hoarseness,were reported during the treatment.Conclusion It indicated that ultrasound-guided SGB significantly reduces the incidence of PSH after TBI,has the preventive effect and improves the patient's neurological function score.These findings underscore the potential therapeutic benefits of SGB;however,additional prospective randomized controlled trials are needed to confirm its efficacy.关键词
超声引导/星状神经节阻滞/重症康复/阵发性交感神经亢进Key words
ultrasound-guided/stellate ganglion block/intensive rehabilitation/paroxysmal sympathetic hyperactivity分类
临床医学引用本文复制引用
赵曦,祝宇耀,金子,桂敏,余斌..超声引导下星状神经节阻滞在颅脑损伤患者阵发性交感神经功能亢进中的应用:一项回顾性队列研究[J].同济大学学报（医学版）,2025,46(5):645-650,6.基金项目
上海市级医院诊疗技术推广及优化管理项目—市级医院康复医学科专科联盟资助(SHDC22023304) （SHDC22023304）
国家临床重点专科建设项(Z155080000004) （Z155080000004）
上海市级医院示范性研究型病房(SHDC2023CRW018B) （SHDC2023CRW018B）
上海市康复医学重中之重研究中心(2023ZZ02027) （2023ZZ02027）
