宫颈癌术后激素水平的改变与术后恶心及呕吐的关系  

Plasma titers of progesterone correlate with the incidence of post operative nausea and vomiting in patients after radical operation of cervical cancer

作　　者：周时蓓[1] 姜辉[1] 谭志明[1] 王华英[2] 任玉兰[2] 

机构地区：[1]复旦大学附属肿瘤医院麻醉科,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院妇瘤科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国癌症杂志》2012年第5期373-376,共4页China Oncology

摘　　要：背景与目的:术后恶心、呕吐(post operative nausea and vomiting,PONV)是一种常见的妇科手术后并发症,发生率较其他腹部手术高3倍以上,可能与手术前后体内雌性激素的变化相关。通过比较手术前后患者体内雌激素(estradiol)、孕激素(progesterone)、黄体生成素(luteinizing hormone,LH)和卵泡刺激素(follicle stimulating hormone,FSH)水平的变化,探讨其与PONV的关系。方法:选择20例在连续硬膜外麻醉复合全身麻醉下行宫颈癌根治手术的患者,在术前、手术结束时及术后5、10及20 h测定其血清雌激素、孕激素、LH和FSH的数值,并在术后5、10及20 h时分别随访患者的恶心呕吐、情况。结果:所有患者的雌激素、孕激素、FSH、LH在术后均有明显的下降。雌激素、FSH和LH的下降与术后恶心、呕吐的发生没有明显关系(P>0.05)。孕激素的下降与术后恶心呕吐发生率呈负相关(P<0.05)。结论:低孕激素水平也许是术后恶心、呕吐的高危因素。Background and purpose： Post operative nausea and vomiting （PONV） is a common complication after gynecological surgeries. Its incidence could be 3 times higher than other abdominal surgeries, and may be due to the changes of plasma titters of sex hormones after surgery. This study aimed to explore the correlation between the changes of plasma titters of estradiol （E2）, progesterone（P）, luteinizing hormone （LH） and follicle stimulating hormone （FSH） before and after radical operation of cervical cancer and the incidence of PONV. Methods： Twenty patients scheduled to receive radical operation of cervical cancer under continuous epidural anesthesia combined with general anesthesia were enrolled in this study. For each patient, plasma titters of E2, P, LH and FSH were measured at the following time points： preoperatively, immediately postoperatively, 5, 10, and 20 h postoperatively. In addition, the incidence of PONV was investigated 5, 10, and 20 h postoperatively. Results： Compared with preoperative levels, the plasma titters of E2, P, LH and FSH of all patients were significantly decreased postoperatively. The down-regulation of progesterone was negatively correlated with PONV （P〈0.05）, while no correlation was detected between the down-regulation of E2, LH or FSH and PONV （P〉0.05）. Conclusion.. Low plasma titter of progesterone may be a risk factor for PONV.

关 键 词：术后恶心 呕吐 雌激素 孕激素 黄体生成素 卵泡刺激素 

分 类 号：R737.33[医药卫生—肿瘤]