静脉自控镇痛和硬膜外自控镇痛对直肠癌术后患者血小板活化的影响  

Effect of PCIA versus PCEA on platelet activation in patients undergoing rectum cancer operation

作　　者：孟海兵[1] 来玮[1] 王信磊[1] 丁国友[1] 张晓光[2] 

机构地区：[1]解放军第九四医院麻醉科,江西南昌330002 [2]上海复旦大学附属中山医院麻醉科,上海200032

出　　处：《中国医药导报》2013年第14期52-54,共3页China Medical Herald

基　　金：国家自然科学基金项目资助(编号81100796)

摘　　要：目的研究分析静脉自控镇痛(PCIA)和硬膜外自控镇痛(PCEA)对直肠癌术后患者血小板活化的影响及意义。方法以解放军第九四医院麻醉科近期收治的46例行直肠癌手术的为研究对象,随机分为两组,每组各23例。实验组患者术后给予PCEA,对照组患者术后给予PCIA,观察对比两组患者术后的血小板活化情况。结果实验组患者术后24、48 h CD62P、CD63的表达水平以及CD41/CD61比值较术后即刻均有明显下降(P<0.05);对照组患者术后24 h CD41/CD61比值较术后即刻明显降低,术后48 h CD62P、CD63的表达水平以及CD41/CD61比值较术后即刻明显下降(P<0.05);实验组术后24、48 h CD62P的表达水平以及CD41/CD61比值均明显低于对照组,术后48 h CD63表达水平明显低于对照组(P<0.05);实验组术后24、48 h活化的部分凝血活酶时间以及凝血酶原时间明显长于对照组,差异具有统计学意义(P<0.05)。结论 PCEA可以抑制血小板的活化,显著改善直肠癌患者术后全身血液的高凝状态,对深静脉血栓的产生具有预防意义,效果优于PCIA。Objective To investigate the effect of PCIA versus PCEA on platelet activation in patients undergoing rectum cancer operation. Methods 46 patients undergoing rectum cancer operation were randomly divided into two groups, each with 23 patients, The experimental group received the PCEA while the control group received the PCIA. The platelet activation were observed in the two group. Results The expression levels of CD62P,CD63 and CD41/ CD61 postoperative 24 h, 48 h in the experimental group were significantly lower than that immediate postoperative （P 〈 0.05）. The CD41/CD61 postoperative 24 h in the control group was significantly lower than that immediate postoperative （P 〈 0.05）. The expression levels of CD62P, CD63 postoperative 48 h in the control group were significantly lower than that immediate postoperative （P 〈 0.05）. The expression levels of CD62P, CD63 and CD41/CD61 postoperative 24 h, 48 h in the experimental group were significantly lower than that in the control group （P 〈 0.05）. The APTr and PT postoperative 24 h, 48 h in the experimental group were significantly longer than that in the control group （P 〈 0.05）. Conclusion PCEA can inhibit the activation of platelet, significantly improve cancer patients＇ systemic blood hypercoagulable state and prevent the generation of DVT.

关 键 词：静脉自控镇痛 硬膜外自控镇痛 直肠癌 血小板 

分 类 号：R735.37[医药卫生—肿瘤]