龙继水

赣南医科大学

摘要(Abstract)：

随着人口老龄化加剧，在接受胸腔镜手术(video-assistedthoracoscopicsurgery,VATS)的老年患者所占比例也越来越大。尽管VATS具有创伤小的优点，但是由于老年人自主神经调节能力减弱及应激反应增强，在围手术期间容易出现内脏疼痛、失眠、血压波动等问题。而星状神经节阻滞(stellateganglionblock,SGB)能够缓解上述症状，近年来被越来越多的应用到围手术期管理中。SGB可以缓解患者的胸部内脏疼痛、减少阿片类药物使用的需求量，改善患者术后睡眠质量、抑制炎症反应以及维持良好的循环稳定状态。一些研究表明SGB还会以帮助促进胃肠道功能恢复、提高整体恢复的质量并且对于老年人群围手术期神经认知功能具有一定的保护作用。在围术期心律失常中，SGB对于交感神经系统介导的心动过速有较好的预防效果但是对于术后房颤（POAF）的作用尚无定论。目前SGB在老年VATS患者的应用已经从单纯的镇痛发展为一种自主神经调节的方法但是其最佳的应用方式及其远期的效果还需更多高质量的研究来证实。

关键词(KeyWords)：

星状神经节阻滞；胸腔镜手术；老年患者；内脏痛；睡眠障碍；应激反应；心律失常；术后认知功能

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