硬膜外镇痛与静脉镇痛对子宫肌瘤患者血清CA125、VEGF-C、PGE2的影响  

The effect of epidural analgesia and intravenous analgesia on serum CA125,VEGF-C and PGE2 in patients with hysteromyoma

作　　者：姚瑶[1] 高瑾[1] YAO Yao;GAO Jin(Department of Anesthesiology,Xiangyang Center Hospital,Hubei Liberal Arts College,Xiangyang,Hubei,441021)

机构地区：[1]湖北文理学院附属襄阳市中心医院麻醉科,湖北襄阳441021

出　　处：《海南医学院学报》2018年第9期935-937,941,共4页Journal of Hainan Medical University

基　　金：中国高校医学期刊临床专项资金项目(11221022)~~

摘　　要：目的:探讨硬膜外镇痛与静脉镇痛对子宫肌瘤患者血清癌抗原125(cancer antigen 125,CA125)、血管内皮生长因子-C(vascular endothelial growth factor-C,VEGF-C)和前列腺素E2(prostaglandin E_2,PGE2)的影响。方法:选自我院于2015年9月至2017年9月期间收治的子宫肌瘤患者98例,按照随机表法分为观察组49例与对照组49例。两组均采用蛛网膜下腔阻滞麻醉。对照组采用自控静脉镇痛,观察组采用硬膜外麻醉。比较两组手术时间和术中出血量,术前和术后VAS评分、CA125、VEGF-C和PGE2水平变化。结果:两组手术时间和术中出血量比较无统计学差异(P>0.05)。两组术后3、24、48hVAS评分较术前降低(P<0.05);观察组术后3、24、48hVAS评分低于同期对照组(P<0.05)。两组术后48h血清CA125、VEGF-C和PGE2水平较术前降低(观察组:t=12.867、16.511、16.674,对照组:t=7.987、7.608、8.425,P<0.05);观察组术后48h血清CA125、VEGFC和PGE2水平低于对照组(t=7.442、10.418、10.682,P<0.05)。结论:硬膜外镇痛对子宫肌瘤效果明显,且可降低CA125、VEGF-C和PGE2水平,具有重要研究意义。Objective： To investigate the effects of epidural analgesia and intravenous analgesia on serum Cancer 125 （antigen 125, CA125）, vascular endothelial growth factor-C （Vascular endothelial growth factor-C, VEGF-C） and prostaglandin E 2 （Prostaglandin VEGF-C） in patients with uterine fibroids. Methods： A total of 98 cases of uterine myoma treated in our hospital between September 2015 and September 2017 were selected and divided into 49 cases in the observation group and 49 cases in the control group according to the random table method. The two groups were all anaesthetized by subarachnoid block. The control group was controlled by self controlled intravenous analgesia, and the observation group was treated with epidural anesthesia. The operation time and the amount of intraoperative bleeding were compared between the two groups, and the changes of preoperative and postoperative 48 h VAS score, CA125, VEGF-C and PGE2 levels. Results： There was no statistical difference between the two groups of operation time and intraoperative bleeding （ P 〉0.05）. Two groups of postoperative 3 h, postoperative 24 h and 48 h VAS score significantly decreased compared with preoperative （ P 〈0.05）; the observation group 3 h, 24 h and 48 h VAS scores were significantly lower than those in the control group （ P 〈0.05）. Two groups of postoperative 48 h serum CA125, VEGF-C and PGE2 levels significantly decreased （the observation group： t =12.867, 16.511, 16.674, the control group： t =7.987, 7.608, 8.425, P 〈0.05）; postoperative 48 h serum CA125, VEGF-C and PGE2 levels after operation in the observation group were significantly lower than in the control group （ t =7.442, 10.418, 10.682, P 〈0.05）. Conclusion： The effect of epidural analgesia on uterine myoma is obvious, and it can reduce the level of CA125, VEGF-C and PGE2, which is of great significance.

关 键 词：硬膜外镇痛 子宫肌瘤 癌抗原125(CA125)血管内皮生长因子-C(VEGF-C)前列腺素E2(PGE2) 

分 类 号：R737.33[医药卫生—肿瘤]