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星状神经节阻滞:蛛网膜下腔出血患者的治疗中还需要包括其他什么内容?

Stellate ganglion block: what else is necessary to include in the treatment of subarachnoid hemorrhage patients?

作者信息

Welling Leonardo C, Rabelo Nicollas Nunes, de Sena Barbosa Mateus Gonçalves, Messias Beatriz Rodrigues, Pinto Carolina Guimarães, Figueiredo Eberval Gadelha

机构信息

Department of Neurosurgery, State University of Ponta Grossa, Ponta Grossa, PR, Brazil.

Division of Neurosurgery, School of Medicine, University of São Paulo (FMUSP)/Hospital das Clínicas, Dr. Enéas de Carvalho Aguiar Street, 255, São Paulo, SP, 05403-010, Brazil.

出版信息

Chin Neurosurg J. 2024 Aug 1;10(1):21. doi: 10.1186/s41016-024-00374-3.

Abstract

Cerebral vasospasm is determined as a temporary narrowing of cerebral arteries a few days after an aneurysmal subarachnoid hemorrhage. The onset of this vascular event usually evolves with new neurological deficits or progression of ischemic areas. The success of interventions to treat or revert this condition is not satisfying. In addition to cerebral vasospasm, early brain injury plays an important role as a contributor to subarachnoid hemorrhage's mortality. In this sense, stellate ganglion block appears as an alternative to reduce sympathetic system's activation, one of the main pathophysiological mechanisms involved in brain injury. Over the past few years, there is growing evidence that stellate ganglion block can contribute to decline patient morbidity from subarachnoid hemorrhage. Is it time to include this procedure as a standard treatment after aneurysm rupture?

摘要

脑血管痉挛被定义为动脉瘤性蛛网膜下腔出血几天后脑动脉的暂时性狭窄。这种血管事件的发作通常伴随着新的神经功能缺损或缺血区域的进展。治疗或逆转这种情况的干预措施的成功率并不令人满意。除了脑血管痉挛外,早期脑损伤作为蛛网膜下腔出血死亡率的一个促成因素也起着重要作用。从这个意义上说,星状神经节阻滞似乎是一种减少交感神经系统激活的替代方法,而交感神经系统激活是脑损伤所涉及的主要病理生理机制之一。在过去几年中,越来越多的证据表明星状神经节阻滞有助于降低蛛网膜下腔出血患者的发病率。是时候将这种治疗方法纳入动脉瘤破裂后的标准治疗了吗?

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Establishment of ultrasound-guided stellate ganglion block in rats.大鼠超声引导下星状神经节阻滞的建立。
Front Neurosci. 2023 Jan 12;16:1061767. doi: 10.3389/fnins.2022.1061767. eCollection 2022.
10
Spontaneous subarachnoid haemorrhage.自发性蛛网膜下腔出血。
Lancet. 2017 Feb 11;389(10069):655-666. doi: 10.1016/S0140-6736(16)30668-7. Epub 2016 Sep 13.

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