| Objectives 1 To discuss the effectiveness and feasibility of using stellate ganglion block(SGB) to treat the lymph edema of upper limb after breast cancer operation. 2 To demonstrate that SGB was superior to conventional therapy in treating lymph edema after comparing. 3 To discuss that compared to conventional SGB, ultrasound–guided SGB was more accurate in puncture point positioning, more effective for operating, and more useful in guiding beginners.Methods Part one Collected 90 cases who received operation of breast cancer in Tangshan people’s hospital affiliated to the North China university were analyzed retrospectively and 90 cases were divided into two groups randomly: control group(n=45) was only treated with conventional therapy and treatment group(n=45) was treated with SGB united with conventional therapy. Information such as general clinical characters and tumor pathologic stage were collected. Two different methods have been used to measure upper limb edema : upper limb week diameter measurement and multi-frequency electrical impedance analyzer. Measurement data was signified by case number and rate, comparison among group was analyzed by Chi-squared test, the difference was significantly when P<0.05. All of the date were analyzed by SPSS19.0 software. Part two Collected 60 cases who received the treatment of SGB in Tangshan people’s hospital affiliated to the North China university of technology and 60 cases were divided into two groups randomly: U group(n=30) was treated with ultrasound–guided SGB and C group(n=30) was treated with traditional blind puncture. All the operations were completed by the same clinician. Operating time, success rate of puncture first time, incidence of Horner syndrome, complications of puncture, the mean effect time after puncture and the time of symptom maintaining were respectively observed and recorded.Results Part one Between control group and treatment group, there was no difference in age, clinical pathologic stage, degree of education, marital status, household income, upper arm circumference before operation(P<0.05). The effective rate of the treatment group is 77.8%, 91.1% for the control group, the difference was significantly when P<0.05. Used T test statistical method to analyze weeks diameter measurement and multifrequency electrical impedance analyzer, the two group all got definitive curative effect(P<0.05), difference were statistically significant after comparison among groups using T test statistical method. Part two There was no difference in onset time, maintaining time of symptom between patients successfully punctured of U group and C group. It demonstrated that the two puncture pattern could get the same effect. The success rate of puncturing first time in U group was 96.7%( patients failed to be punctured at first time presented Horner syndrome after medicine injecting in the second puncturing). The success rate of puncturing first time in C group was 86.7%, the difference was significantly between U and C group. The rate of Horner syndrome in U group was 100%, 90% for the C group, the difference was significantly when P<0.05. There was no puncturing complication in U group, and 13.3% in C group( one case of strange feeling of puncturing, one case of blood return, two cases of trachyphonia), the difference was significantly when P<0.05.Conclusions SGB was certainly effective in curing lymph edema after breast cancer operation. It could shrink the differential of upper limb week diameter of healthy side and affected side and alleviate the moisture content of upper limb in affected side. The SGB and conventional therapeutic have been all effective, and the experiment showed that the former is superior than the latter.Compared to conventional SGB, the ultrasonic guidance SGB was accurate in locating puncture point, more effective for operator, more useful in guiding beginner. |
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