TIVA对新辅助化疗后行乳腺癌改良根治术患者骨髓功能及肝肾功能的影响  

Effects of TIVA on marrow function,liver and renal functions in patients undergoing modified radical mastectomy of breast cancer after neoadjuvant chemotherapy

作　　者：马倩[1] 马富强[2] 陈学新[2] 刘海波[1] 摆志霞[1] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学总医院肿瘤医院麻醉科,宁夏银川750004

出　　处：《宁夏医学杂志》2015年第8期694-696,共3页Ningxia Medical Journal

基　　金：宁夏医科大学面上资助项目(XZ2012005)

摘　　要：目的评估全凭静脉麻醉(TIVA)对新辅助化疗后乳腺癌改良根治术患者围术期骨髓功能及肝肾功能的影响。方法收集肿瘤外科住院择期行全麻下行乳腺癌根治手术患者病例资料1 076例,将术前是否行新辅助化疗分2组,其中化疗组143例,非化疗组(对照组)164例。分析2组患者术前、术后外周血WBC(白细胞计数)、RBC(红细胞计数)、PLT(血小板计数)、AST(谷草转氨酶)、ALT(谷丙转氨酶)、BUN(尿素氮)及SCr(血肌酐)数值。结果术前化疗组各项指标较对照组差异无计学意义(P>0.05);对照组术后较术前各项指标改变差异无统计学意义(P>0.05);化疗组术后较术前外周血PLT明显减少,差异有统计学意义(P<0.05);术后化疗组较对照组外周血WBC、PLT明显减少,差异有统计学意义(P<0.05)。结论全凭静脉麻醉可影响化疗后患者骨髓功能,主要以抑制外周血中WBC和PLT为主;全凭静脉麻醉对新辅助化疗后患者肝肾功能无明显影响。Objective To evaluate the effects of total intravenous anesthesia （TIVA） on perioperative marrow function, liver and renal functions in patients undergoing modified radical mastectomy of breast cancer after neoadjuvant chemotherapy. Methods The data of 1076 patients underwent elective radical mastectomy of breast cancer at the department of surgical oncology,were collected. Ac- cording to the inclusion and exclusion criteria after whether neoadjuvant chemotherapy was used before surgery, the cases were divided in- to two groups. The chemotherapy group was 143 Cases and the non - chemotherapy group （ control group） was 164 cases. The values of peripheral white blood cell （WBC）, red blood cell （ RBC ）, platelet （ PLT）, AST （ aspartate aminotransferase ）, ALT （ alanine amin- otransferase）, BUN （blood urea nitrogen） and SCr （serum creatinine） in the preoperative and postoperative were analyzed and counted. Results The postoperative indicators were no significant difference compared to preoperative in control group （ P 〉 0.05 ）. There were no significant changes in the preoperative indicators in chemotherapy group compared to control group （ P 〉 0． 05 ）. The values of postop- erative PLT was significantly reduced compared to preoperative in chemotherapy group, which has a statistically significant difference （P 〈 0.05 ）. The values of postoperative WBC and PLT were lower in chemotherapy group than control group, and statistically significant differences were found in the indicators （P 〈 0.05）. Conclusion The TIVA has effects on marrow function in patients underwent chem- otherapy, mainly in suppression of WBC and PLT,but no effects on liver and renal functions in patients with neoadjuvant chemotherapy.

关 键 词：乳腺癌 骨髓功能 新辅助化疗 全凭静脉麻醉 

分 类 号：R737.9[医药卫生—肿瘤]