全麻联合胸椎旁阻滞对乳腺癌改良根治术术后镇痛及炎性反应的影响  

Effect of general anesthesia combined with thoracic paravertebral block on postoperative analgesia and inflammatory reaction in modified radical mastectomy for breast cancer

作　　者：苏向上[1] 朱旭[1] SU Xiangshang;ZHU Xu(Department of Anesthesia, Xiarnen Hospital of Traditional Chinese Medicine, Xiarnen , Fujian 361009, China)

机构地区：[1]福建省厦门市中医院麻醉科,厦门361009

出　　处：《福建医药杂志》2018年第2期14-17,共4页Fujian Medical Journal

摘　　要：目的观察全麻联合胸椎旁阻滞对乳腺癌改良根治术术后镇痛及炎性反应的影响。方法选取我院2015年3月至2017年7月接受改良根治术治疗的乳腺癌女性患者100例,根据随机数字表法分为观察组及对照组,每组各50例。两组患者均接受乳腺癌改良根治术治疗,对照组术中麻醉施以全麻,观察组则施以全麻联合胸椎旁阻滞。对比两组术前及术后各时点炎性反应相关指标水平变化情况及术后各时点镇痛效果。结果术后各时点,观察组IL-6、TNF-α水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(P<0.05);术后各时点,观察组安静时及运动时的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。结论乳腺癌改良根治术施以全麻联合胸椎旁阻滞麻醉效果较单用全麻好,患者术后不会出现较严重的炎症反应,且镇痛效果理想,利于患者术后早期活动,促进身体机能更好更快地康复,临床效果显著。Objective To observe the effect of general anesthesia（GA）combined with thoracic paravertebral block（TPVB）on postoperative analgesia and inflammatory reaction in modified radical mastectomy（MRM）for breast cancer.Methods One hundred cases of breast cancer treated with MRM from March 2015 to July 2017 were divided into observation group and control group by random number table,with 50 cases in each group.Two groups received MRM,control group took GA,observation group took GA and TPVB.The changes of inflammatory reaction index and analgesic effect of two groups were compared.Results After surgery at each time,IL-6 and TNF-αlevels of observation group were lower than those of control group,IL-10 level was higher than that of control group（P〈0.05）;after surgery,VAS scores at rest and motion in observation group were lower than those in control group（P〈0.05）.Conclusion The anesthetic effect of GA and TPVB is better than GA.GA and TPVB can reduce inflammatory reaction,and improve postoperative activity and promote early recovery.

关 键 词：乳腺癌 改良根治术 全麻 胸椎旁阻滞 术后镇痛 炎性反应 

分 类 号：R614[医药卫生—麻醉学] R737.9[医药卫生—外科学]