| BackgroundShoulder-hand syndrome (SHS) after stroke is the syndrome with pain in the hand, wrist, shoulder, and dyskinesia as the major performance, which also known as reflex sympathetic dystrophy (RSD), it is a common complication of stroke patient with a morbidity of 12.5%-70%. SHS is a common complication of stroke patient which greatly affect the functional recovery of paralytic upper limb movement, which will result in permanent dysfunction of hand, wrist, and shoulder if not given timely and properly treatment, places a heavy burden on their families and on society as well. Therefore, the curative effect of SHS plays an important part in the recovery of stroke patient, while there is still no accurate method which has curative effect on it at present. Shoulder-hand syndrome after stroke is one of the focal points and hot problems of studying in the field of neurology and rehabilitation. Therefore, exploring the effective treatment of shoulder-hand syndrome after stroke is of great significance.ObjectiveEvaluate the clinical curative effect and security of stellate ganglion block (SGB) combine with the routine rehabilitation treatment in the treatment of shoulder-hand syndrome (SHS) after stroke, thus providing a effective method for the treatment of shoulder- hand syndrome after stroke.MethodsA total of 56 patients with SHS in the department of rehabilitation medicine and neurology of the Fourth Affiliated Hospital of Zhengzhou University from March 2012 to March 2014 were included. According to the random number table, they were equally divided into control group with routine rehabilitation treatment and experimental group with stellate ganglion block treatment based on routine rehabilitation treatment. There were 28 cases in experimental group with average age was (58.2±7.4) years old, contained 18 male and 10 female, while 28 cases in the control group with average age was (54.2±10.8) years old, contained 16 male and 12 female. There was no statistical significance between the two groups’general data. The SHS assessment scale score, the visual analogue scale (VAS), the upper limb simplification Fugl-Meyer Assessment (FMA), the daily life ability before and after 14 days treatment were used to evaluate the modified pap index (MBI), and the national institutes of health stroke scale (NIHSS). Results1. The SHS assessment scale scores of the experiment group and the control group before treatment were 11.36±2.14 and 11.80±1.80, respectively, and there were no statistical difference between the two groups. The SHS scores of the experiment group and the control group after 14 d treatment were 5.26±2.24 and 8.64±2.46, respectively, and there were significant difference between the two groups, the experiment group was much better than that of the control group (P< 0.05).2. The pain visual analogue scale (VAS) of the experiment group and the control group before treatment were 7.18±2.17 and 6.89±2.24, respectively, and there were no statistical difference between the two groups. The VAS of the experiment group and the control group after 14 d treatment were 2.21±2.14 and 5.14±2.21, respectively, and there were significant difference between the two groups, the experiment group was much better than that of the control group (P< 0.05).3. The Fugl-Meyer Assessment (FMA) scores of the experiment group and the control group before treatment were 5.74±3.16 and 5.86±3.32, respectively, and there were no statistical significance between the two groups. The FMA scores of the experiment group and the control group after 14 d treatment were 18.13±3.24 and 12.84±4.56, respectively, and there were statistical significance between the two groups, the experiment group was much better than that of the control group (P< 0.05).4. The modified pap index (MBI) scores of the experiment group and the control group before treatment were 70.98±15.12 and 71.56±14.84, respectively, and there were no statistical significance between the two groups. The MBI scores of the experiment group and the control group after 14 d treatment were 76.28±12.14 and 74.32±10.24, respectively, and there were statistical significance between the two groups (P< 0.05).5. The NIHSS scores of the experiment group and the control group before treatment were 5.86±4.42 and 6.12±4.84, respectively, and there were no statistical significance between the two groups. The NIHSS scores of the experiment group and the control group after 14 d treatment were 4.08±4.52 and 4.43±4.46, respectively, and there were statistical significance between the two groups (P< 0.05).6. The total effective rate of the experiment group and the control group after 14 d treatment were 96.43% and 71.43%, respectively, and both groups had remarkable curative effect, the experimental group was significantly higher than that of the control group (χ2=25.188, p<0.05). There were no obvious adverse reactions in both groups during the therapeutic process.Conclusion1. The stellate ganglion block treatment could effectively improve the upper limb movement function and pain scale of stroke patients with shoulder hand syndrome.2. The stellate ganglion block treatment for the treatment of shoulder hand syndrome after stroke was safe and effective, no obvious adverse reactions, worthy of clinical promotion. |
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