星状神经节阻滞用于心脏术后患者的难治性电风暴：病例报告
Stellate Ganglion Block for Refractory Electrical Storm in Cardiac Surgery Patient: A Case Report
DOI: 10.12677/acm.2025.154958, PDF,   
作者: 梁静雯*：绍兴文理学院医学院，浙江 绍兴；张 俊*, 陈 钢#：浙江大学医学院附属邵逸夫医院麻醉科，浙江 杭州
关键词: 室颤；电风暴；室性心律失常；星状神经节阻滞；Ventricular Fibrillation； Electrical Strom； Ventricular Arrhythmia； Stellate Ganglion Block
摘要: 电风暴的定义为：在24小时内出现超过3次且间隔时间大于5分钟的持续性室性心动过速，常常危及患者生命安全。在本医疗中心，一位66岁的女性在体外循环冠状动脉旁路移植术及二尖瓣修复手术后，出现了反复发作的电风暴。尽管实施了适当的抗心律失常药物治疗，并结合镇静和其他常规治疗措施，但效果甚微，并且依赖电除颤终止电风暴状态。随后，治疗团队依次尝试了四次“星状神经节阻滞”以终止电风暴，并取得了成功。令人惊讶的是，我们尝试通过异丙肾上腺素缩短QT间期，但在此期间电风暴再次大量爆发。最终，我们停止使用异丙肾上腺素并进行了最后一次星状神经节阻滞，电风暴随即停止。
Abstract: 66-year-old women suffered refractory life-frightening electrical storm after on-pump coronary artery bypass grafting and mitral valve repair surgery. Appropriate anti-arrythmia drugs were implemented, combined with sedation and other regular treatments, but minimal effect occurred. Defibrillation was the sole efficacious intervention in this case. We tried four doses of stellate ganglion block in turn to terminate ES and succeeded. Astonishingly, we attempted to do shorten QTc by isoproterenol, but ES rousted in this period. Finally, we stopped using isoproterenol and preformed the last dose of SGB, ES ceased soon.
文章引用：梁静雯, 张俊, 陈钢. 星状神经节阻滞用于心脏术后患者的难治性电风暴：病例报告[J]. 临床医学进展, 2025, 15(4): 492-496. https://doi.org/10.12677/acm.2025.154958

参考文献

[1] Jentzer, J.C., Noseworthy, P.A., Kashou, A.H., May, A.M., Chrispin, J., Kabra, R., et al. (2023) Multidisciplinary Critical Care Management of Electrical Storm. Journal of the American College of Cardiology, 81, 2189-2206. [Google Scholar] [CrossRef] [PubMed]
[2] Savastano, S., Dusi, V., Baldi, E., Rordorf, R., Sanzo, A., Camporotondo, R., et al. (2020) Anatomical-Based Percutaneous Left Stellate Ganglion Block in Patients with Drug-Refractory Electrical Storm and Structural Heart Disease: A Single-Centre Case Series. EP Europace, 23, 581-586. [Google Scholar] [CrossRef] [PubMed]
[3] Zeppenfeld, K., Tfelt-Hansen, J., De Riva, M., et al. (2022) 2022 ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death. European Heart Journal, 43, 3997-4126.
[4] Yanowitz, F., Preston, J.B. and Abildskov, J.A. (1966) Functional Distribution of Right and Left Stellate Innervation to the Ventricles. Production of Neurogenic Electrocardiographic Changes by Unilateral Alteration of Sympathetic Tone. Circulation Research, 18, 416-428. [Google Scholar] [CrossRef] [PubMed]
[5] Kapa, S., DeSimone, C.V. and Asirvatham, S.J. (2016) Innervation of the Heart: An Invisible Grid within a Black Box. Trends in Cardiovascular Medicine, 26, 245-257. [Google Scholar] [CrossRef] [PubMed]
[6] Small, K.M., Wagoner, L.E., Levin, A.M., Kardia, S.L.R. and Liggett, S.B. (2002) Synergistic Polymorphisms of β1-and α2c-Adrenergic Receptors and the Risk of Congestive Heart Failure. New England Journal of Medicine, 347, 1135-1142. [Google Scholar] [CrossRef] [PubMed]
[7] Savastano, S., Baldi, E., Compagnoni, S., et al. (2024) Electrical Storm Treatment by Percutaneous Stellate Ganglion Block: The STAR Study. European Heart Journal, 45, 823-833.
[8] Fudim, M., Boortz‐Marx, R., Ganesh, A., Waldron, N.H., Qadri, Y.J., Patel, C.B., et al. (2017) Stellate Ganglion Blockade for the Treatment of Refractory Ventricular Arrhythmias: A Systematic Review and Meta‐Analysis. Journal of Cardiovascular Electrophysiology, 28, 1460-1467. [Google Scholar] [CrossRef] [PubMed]
[9] Vaseghi, M., Barwad, P., Malavassi Corrales, F.J., Tandri, H., Mathuria, N., Shah, R., et al. (2017) Cardiac Sympathetic Denervation for Refractory Ventricular Arrhythmias. Journal of the American College of Cardiology, 69, 3070-3080. [Google Scholar] [CrossRef] [PubMed]
[10] Vaseghi, M., Gima, J., Kanaan, C., Ajijola, O.A., Marmureanu, A., Mahajan, A., et al. (2014) Cardiac Sympathetic Denervation in Patients with Refractory Ventricular Arrhythmias or Electrical Storm: Intermediate and Long-Term Follow-Up. Heart Rhythm, 11, 360-366. [Google Scholar] [CrossRef] [PubMed]

为你推荐