术后镇痛对胃癌根治术病人血浆内皮素-1影响  

THE EFFECTION OF POSTOPERATIVE ANALGESIA PLASMA ENDOTHELIN-1 IN PATIENTS WITH GASTRIC CARCINOMA RADICAL OPERATION

作　　者：查木哈格[1] 侯明星[1] 姚国栋[1] 

机构地区：[1]内蒙古医科大学附属医院普外科,内蒙古呼和浩特010050

出　　处：《内蒙古医科大学学报》2013年第6期425-428,433,共5页Journal of Inner Mongolia Medical University

基　　金：内蒙古自然科学基金项目(2012MS1180)

摘　　要：目的:应激状态下血浆内皮素-1(Endothelin;ET)是损伤胃黏膜的重要致病因子。痛会引起强烈的应激反应,通过检测胃癌术后病人外周血中ET-1水平,从而探讨有效术后镇痛对胃癌病人术后血浆ET-1有何影响。方法:50例ASAI级或II级择期行胃癌根治术病人,随机均分为两组:镇痛组与对照组(未行镇痛组),各25例,记录术后6 h、12 h、24 h静息疼痛视觉模拟评分(VAS)和Ram-Say镇静评分及术后肛门排气时间、拔胃管时间、进食流质时间。分别于术前、术后6、12 h采外周血应用放射免疫法检测血浆ET-1的水平。结果:镇痛组与对照组两组病人术前ET-1水平无显著差异,而在术后6 h与术后12 h的时间点上两组血浆ET-1水平均有有明显差异(P<0.05),镇痛组术后ET-1水平明显低于对照组。各组内不同时间点指标比较:对照组ET-1水平在各时间点均有明显差异(P<0.05),术后6 h ET-1水平最高,术后12 h ET-1水平次之,但都高于术前;镇痛组在不同时间点的ET-1水平均无明显差异。结论:有效的术后镇痛可抑制血浆ET-1水平升高,从而降低由ET-1对胃黏膜的损伤,术后镇痛对胃癌根治术病人术后恢复是有益的。Objective:Under stress ( Endothelin;ET) is an important pathogenic factor of gastric mucosal injury. Pain may cause a strong stress response, by detecting the peripheral blood of gastric carcinoma patients plasma endothelin-1(ET-1)levels. To explore effective postoperative analgesia on postoperative gastric carcinoma patients plasma ET-1 impact. Methods:50 cases of ASAI or II grade elective resection of gastric carcinoma patients were randomly divided into two groups:Analgesia group and the control group(no analgesia group)of the 25 cases. Record after 6 h,12 h,24 h resting pain visual analogue scale( VAS) and Ram-Say sedation and postoperative anal exhaust time,pulling tube time,eating liquid time,Respectively,before operation 6 h、after 12 h blood detecting sample of plasma ET-1 levels by radioimmunoassay. Results:Two groups of patients before operation no difference at ET -1 levels,In the postoperative time of 6 h and 12 h ET-1 levels are significantly different(P<0. 05), ET-1 analgesia group were significantly lower than the control group. Through the different time points within the each group Comparative, the control group of ET-1 levels at each time point were significantly different(P<0. 05),Postoperative 6 h ET-1 levels the highest,Postoperative 12 h ET-1 was second,but higher than preoperative,Analgesia group at different time points of ET-1 levels were not significantly different. Conclusion:Effective postoperative analgesia can inhibit plasma levels of ET-1, Reducing gastric mucosal injury. This research found that patients of gastric carcinoma postoperative radical operation recovery of gastrointestinal function are useful.

关 键 词：胃癌 术后镇痛 内皮素-1 

分 类 号：R73[医药卫生—肿瘤] R45[医药卫生—临床医学]