超声引导下星状神经节阻滞治疗主观性耳鸣临床实践专家共识

Expert consensus on the clinical practice of ultrasound-guided stellate ganglion block for the treatment of subjective tinnitus

  • 摘要: 主观性耳鸣是在外界缺乏声源或电刺激的情况下,个体感觉到的异常听觉体验。耳鸣发生后常常伴随睡眠障碍、情绪障碍及植物神经系统功能障碍,其中交感神经过度兴奋最常见,而且是对患者影响极大的伴随症状(或共病状态)。星状神经节阻滞(SGB)将局部麻醉药物注入星状神经节周围的疏松结缔组织中,阻滞颈交感干、颈交感神经节、节前与节后神经及其支配范围的神经纤维,通过调节交感神经张力,达到调节人体自主神经系统、循环系统、免疫系统和神经内分泌功能,并使其达到动态平衡的目的。前期临床实践表明,SGB治疗主观性耳鸣可获得满意疗效,但主观性耳鸣异质性高,为了规范SGB的适应证及干预流程,此共识旨在为临床医师应用 SGB 治疗主观性耳鸣提供参考。

     

    Abstract: Subjective tinnitus is an abnormal auditory perception experienced by an individual in the absence of external sound sources or electrical stimulation.Tinnitus is often accompanied by sleep disturbances, emotional disorders, and autonomic nervous system dysfunction, among which excessive sympathetic nerve excitation is the most common and significantly impacts patients.Stellate ganglion block (SGB) involves injecting local anaesthetic into the loose connective tissue surrounding the stellate ganglion to block the cervical sympathetic trunk, cervical sympathetic ganglion, preganglionic and postganglionic nerves, and the nerve fibres within their distribution. By modulating the sympathetic nerve tone, it aims to regulate the autonomic nervous system, circulatory system, immune system, and neuroendocrine function, achieving a state of dynamic balance in the body.Preliminary clinical practice indicates that SGB treatment achieves satisfactory efficacy for subjective tinnitus; however, subjective tinnitus exhibits significant heterogeneity. To further clarify indications and standardise intervention procedures, this consensus aims to provide guidance for clinicians on the use of SGB in treating subjective tinnitus.

     

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