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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 305 -309. doi: 10.11817/j.issn.1673-9248.2022.05.003

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星状神经节阻滞对颅脑循环和认知功能影响及意义的研究进展
逯佳1, 王增涛1, 陈茜1, 张洁1,()   
  1. 1. 201906 上海,复旦大学附属华山医院北院麻醉科
  • 收稿日期:2021-12-26 出版日期:2022-10-01
  • 通信作者: 张洁
  • 基金资助:
    上海市卫生与健康委员会科研课题面上项目(201740008)

Effects of stellate ganglion block on cerebral circulation and cognitive function

Jia Lu1, Zengtao Wang1, Qian Chen1, Jie Zhang1,()   

  1. 1. Department of Anesthesiology, Huashan Hospital North Affiliated to Fudan University, Shanghai 201906, China
  • Received:2021-12-26 Published:2022-10-01
  • Corresponding author: Jie Zhang
引用本文:

逯佳, 王增涛, 陈茜, 张洁. 星状神经节阻滞对颅脑循环和认知功能影响及意义的研究进展[J/OL]. 中华脑血管病杂志(电子版), 2022, 16(05): 305-309.

Jia Lu, Zengtao Wang, Qian Chen, Jie Zhang. Effects of stellate ganglion block on cerebral circulation and cognitive function[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(05): 305-309.

星状神经节阻滞(SGB)技术是临床麻醉治疗学最常用的方法。近些年SGB不仅用于治疗急慢性疼痛,还用于循环系统、免疫系统和神经系统等的慢性难治性非疼痛性疾病的治疗。神经系统疾病的相关研究发现,SGB对颅脑循环和认知功能的调节,是预防和治疗颅脑血管损伤相关并发症、创伤后应激障碍和术后认知功能障碍的基础和前提。SGB可以选择性阻断交感神经通路的信号传导,抑制肾上腺能受体的活性,维持交感神经与副交感神经在血管舒缩功能的平衡和调节颅内炎症因子的浓度,从而调节颅脑循环,治疗颅内血管痉挛和血管损伤继发的相关并发症。大脑的认知功能同样与自主神经的调节密不可分,SGB对认知功能的影响可能与阻断下丘脑-交感神经-肾上腺轴和抑制免疫机制的过度活化相关。现阶段的研究中可以发现SGB通过调节自主神经平衡,改变大脑内环境状态来影响颅脑循环和大脑认知功能,为临床疾病的良性转归发挥积极作用。

Stellate ganglion block (SGB) is the most commonly method in clinical anesthesiology. In recent years, SGB is not only applied in acute and chronic pain, but also in the chronic refractory non-painful diseases, such as circulatory diseases, immune diseases and nervous system diseases. In the studies related to nervous system diseases, it is found that the regulation of SGB on craniocerebral circulation and cognitive function is fundamental for preventing and treating of complications related to craniocerebral vascular injury, post-traumatic stress disorder (PTSD) and postoperative cognitive impairment. SGB can selectively block the signal transduction of sympathetic pathway, inhibit the activity of adrenergic receptor, maintain the balance of vasomotor function between sympathetic nerve and parasympathetic nerve, and regulate the concentration of intracranial inflammatory factors. All these functions are helpful to regulate craniocerebral circulation and treat the related complications secondary to intracranial vasospasm and vascular injury. The cognitive function of the brain is also inseparable from the regulation of autonomic nerve. The effect of SGB on cognitive function may be related to blocking the hypothalamus-sympathetic nerve-adrenal axis and inhibiting the overactivation of immune. In the current research, it can be found that SGB affects brain circulation and brain cognitive function by regulating autonomic nerve balance and changing the state of brain environment, which plays a positive role in the benign prognosis of clinical diseases.

图1 血流调节的“双重控制机制”示意图
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