摘要
目的:探讨超声引导下胸椎旁阻滞联合全身麻醉对乳腺癌改良根治术后疼痛相关介质分泌的影响。方法:选择在本院接受乳腺癌改良根治术治疗的乳腺癌患者108例,经随机数表法分为对照组、椎旁阻滞组各54例。对照组接受常规全身麻醉,椎旁阻滞组患者接受超声引导下胸椎旁阻滞联合全身麻醉。对比两组患者手术结束即刻(T0)、术后6h(T1)、术后12h(T2)、术后24h(T3)血清中疼痛介质、炎症因子、应激激素含量的差异。结果:T0时,两组血清中疼痛介质、炎症因子、应激激素含量的差异无统计学意义。T1、T2、T3时,椎旁阻滞组血清中疼痛介质NPY、PGE_2、5-HT的含量低于对照组;血清中炎症因子IL-1、IL-6、TNF-α、MCP-1的含量低于对照组;血清中应激激素ACTH、Cor、AngⅠ、AngⅡ的含量低于对照组。结论:乳腺癌改良根治术患者接受超声引导下胸椎旁阻滞联合全身麻醉,可有效减轻患者术后疼痛介质的释放,减轻全身炎症应激反应。
Objective:To investigate the effects of ultrasound-guided thoracic paravertebral block combined with general anesthesia on the secretion of pain-related mediators after modified radical mastectomy.Methods:A total of 108 patients with breast cancer who were treated with modified radical mastectomy in this hospital between July 2015 and February 2017 were divided into the control group(n=54)and paravertebral block group(n=54)by random number table.Control group received routine general anesthesia,and paravertebral block group received ultrasound-guided thoracic paravertebral block combined with general anesthesia.The differences in serum levels of pain mediators,inflammatory factors and stress hormones were compared between the two groups of patients immediately after surgery(T0),6 hafter surgery(T1),12 hafter surgery(T2)and 24 hafter surgery(T3).Results:At T0,there was no statistically significant difference in serum levels of pain mediators,inflammatory factors and stress hormones between the two groups.At T1,T2 and T3,serum pain mediators NPY,PGE_2 and5-HT levels of paravertebral block group were lower than those of control group;serum inflammatory factors IL-1,IL-6,TNF-αand MCP-1 levels were lower than those of control group;serum stress hormones ACTH,Cor,AngⅠ and AngⅡlevels were lower than those of control group.Conclusion:ultrasound-guided thoracic paravertebral block combined with general anesthesia can effectively reduce the release of pain mediators and relieve the systemic inflammatory stress response after modified radical mastectomy.
出处
《海南医学院学报》
CAS
2018年第1期45-48,共4页
Journal of Hainan Medical University
基金
湖北省卫计委科技计划项目(WJ2015Z132)~~
关键词
乳腺癌改良根治术
超声引导下胸椎旁阻滞
疼痛介质
炎症因子
应激激素
Modified radical mastectomy
Ultrasound-guided thoracic paravertebral block
Pain mediator
Inflamma tory factor
Stress hormone
