对比超声引导下经C6与C7横突平面入路星状神经节阻滞的有效性和安全性

目的 对比观察超声引导下经C6与C7横突平面入路行星状神经节阻滞（SGB）的有效性及安全性。方法 选取80例接受超声引导下SGB治疗患者，超声显示C6横突前结节与颈动脉距离>5 mm，且C7水平椎静脉与颈动脉间距离>5 mm；按入院顺序随机将其分为C6组（C6横突平面入路）和C7组（C7横突平面入路），每组40例，每日穿刺给药1次，连续6~10天。记录治疗6日后2组平均每次药物剂量，统计霍纳综合征出现时间及持续时间；比较治疗前、后视觉模拟量表（VAS）评分；观察不良反应。结果 6日内每组均顺利完成240次超声引导下SGB，并均出现霍纳综合征。C7组拔出穿刺针后1、2 min出现霍纳综合征次数高于C6组（P均<0.05），而5、10 min后出现次数低于C6组（P均<0.05）；C7组霍纳综合征持续3 h次数低于C6组（P<0.05），持续5、6 h次数高于C6组（P均<0.05）。C7组平均每次药物剂量低于C6组（P<0.01）。治疗前2组VAS评分差异无统计学意义（P>0.05），治疗6日后C7组VAS评分低于C6组（P<0.05）。期间C6组出现声音嘶哑12次（12/240，5.00%）、C7组3次（3/240，1.25%），前者多于后者（P<0.05）。2组均未见其他不良反应。结论 超声引导下C7横突平面入路行SGB的有效性及安全性均优于经C6平面入路。

Comparison on efficacy and safety of ultrasound-guided stellate ganglion block through C6 and C7 transverse process plane approaches

Objective To compare the efficacy and safety of ultrasound-guided stellate ganglion block (SGB) through C6 and C7 transverse process plane approaches. Methods Eighty patients who underwent ultrasound-guided SGB treatment were enrolled. Ultrasound scanning showed the distance between C6 transverse process anterior node and carotid artery >5 mm, and the distance between C7 level vertebral vein and carotid artery >5 mm in all cases. The patients were randomly divided into group C6 (C6 transverse plane approach) and group C7 (C7 transverse plane approach) according to the order of admission (each n=40). Drug administrations were performed through puncture once a day for 6-10 days. After 6 days treatment, the average dose per time in both groups were recorded, the occurrence time and duration of Horner syndrome were counted. Then the scores of visual analogue scale (VAS) before and after treatment were compared, and the adverse reactions were recorded. Results Totally 240 times of SGB were successfully completed under the guidance of ultrasound within 6 days in each group, and Horner syndrome was noticed in both groups. One and 2 minutes after pulling out the needle, the times of Horner syndrome in C7 group were more than that in C6 group (both P<0.05), while 5 and 10 minutes after pulling out the needle, the times of Horner syndrome in C7 group were less than that in C6 group (both P<0.05). The times of Horner syndrome lasting for 3 h in C7 group was less than that of C6 group (both P<0.05), while of Horner syndrome lasting for 5 h and 6 h were more than that in C6 group (both P<0.05). The average drug dose per injection in C7 group was lower than C6 group (P<0.01). There was no significant difference of VAS score between groups before treatment (P>0.05), while after 6 days of treatment, VAS score in C7 group was lower than that in C6 group (P<0.05). Hoarseness occurred 12 times (12/240, 5.00%) in C6 group and 3 times (3/240, 1.25%) in C7 group, in the former was more than in the latter (P<0.05). No other adverse reaction occurred in both groups. Conclusion Ultrasound-guided SGB through C7 transverse process plane approach was more effective and safe than through C6 plane approach.