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使用生物电阻抗分析探讨星状神经节阻滞对中风后复杂性区域疼痛综合征患者的有效性:一项回顾性试点研究。

Use of Bioelectrical Impedance Analysis to Explore the Effectiveness of Stellate Ganglion Block in Patients with Post-Stroke Complex Regional Pain Syndrome: A Retrospective Pilot Study.

作者信息

Ryu Jin-Whan, Hwang In-Su, Lim Seung-Kyu

机构信息

Department of Rehabilitation Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan 31151, Republic of Korea.

出版信息

J Pers Med. 2024 Feb 28;14(3):258. doi: 10.3390/jpm14030258.

Abstract

Post-stroke complex regional pain syndrome (CRPS) poses challenges in pain assessment for survivors. Stellate ganglion block (SGB) is a treatment, but evaluating its effectiveness is difficult for patients with communication limitations. Edema, a prominent symptom, can serve as an evaluation marker. Bioelectrical impedance analysis (BIA), assessing body composition and fluid status, is used independently of patient cooperation. This retrospective, observational pilot study aims to explore BIA's utility as an assessment tool post-SGB, revealing the effects and time courses of a single SGB on the bodily composition of post-stroke CRPS patients. Seven patients received ultrasound-guided SGB with a 5 mL solution containing 4 mL of 0.25% bupivacaine hydrochloride and 40 mg of triamcinolone into the prevertebral muscle space. BIA compared measures between affected and unaffected arms. The affected arm had higher segmental body water (SBW) and extracellular water ratios before SGB ( = 0.028 and = 0.018, respectively). The SBW of the affected side, the SBW ratio, and the 1 and 5 kHz SFBIA ratios improved over time ( = 0.025, 0.008, 0.001, and 0.005, respectively). Rapid improvement occurred around 3 days post-injection, with maximum effects within approximately 1 week, persisting up to 3 weeks. SGB successfully reduced edema in post-stroke CRPS patients, with BIA serving as a useful tool for follow-up, facilitating the development of efficient treatment plans.

摘要

中风后复杂性区域疼痛综合征(CRPS)给幸存者的疼痛评估带来了挑战。星状神经节阻滞(SGB)是一种治疗方法,但对于存在沟通障碍的患者而言,评估其有效性较为困难。水肿是一个突出症状,可作为评估指标。生物电阻抗分析(BIA)用于评估身体成分和液体状态,其使用无需患者配合。这项回顾性观察性试点研究旨在探讨BIA作为SGB后评估工具的效用,揭示单次SGB对中风后CRPS患者身体成分的影响及时间进程。7例患者接受了超声引导下的SGB,将含有4 mL 0.25%盐酸布比卡因和40 mg曲安奈德的5 mL溶液注入椎前肌间隙。BIA比较了患侧和未患侧手臂的测量值。在SGB前,患侧手臂的节段性身体水分(SBW)和细胞外水分比率较高(分别为 = 0.028和 = 0.018)。患侧的SBW、SBW比率以及1 kHz和5 kHz的SFBIA比率随时间改善(分别为 = 0.025、0.008、0.001和0.005)。注射后约3天出现快速改善,在约1周内达到最大效果,持续至3周。SGB成功减轻了中风后CRPS患者的水肿,BIA作为随访的有用工具,有助于制定有效的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf33/10971433/0ba65d3a8743/jpm-14-00258-g001.jpg

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