超声引导前锯肌平面阻滞复合全麻对乳腺癌改良根治术炎性反应的影响  

Effect of ultrasound guided serratus anterior block combined with general anesthesia on inflammatory response in modi. fied radical mastectomy of breast cancer

作　　者：杨成亮 祁富伟[2] 张文娟 沈健[1] 杨广宇[1] 何静[1] 费凡 郭强 郑重[1] 赵秀华[1] Yang Chengliang;Qi Fuwei;Zhang Wenjuan(The First People's Hospital of Taicang, Taicang 215400, Jiangsu, China)

机构地区：[1]太仓市第一人民医院,江苏太仓215400 [2]太仓市第一人民医院麻醉科,江苏太仓215400

出　　处：《医院与医学》2019年第3期69-72,共4页Hospital and Medicine

基　　金：省级大学生创新创业训练计划资助项目(201913993001Y,201913993021H);太仓市科技局重点研发计划(TC2017SFYL07).

摘　　要：目的探讨超声引导下前锯肌平面阻滞复合全麻对乳腺癌改良根治术炎性反应和血流动力学的影响。方法择期乳腺癌改良根治术患者40例,年龄35~68岁,体重52~78kg,ASAⅠ~Ⅱ级,随机分为超声引导下前锯肌平面阻滞复合全麻组(SA组)和单纯全麻组(GA组),每组20例。SA组在超声引导下行前锯肌平面阻滞。分别于麻醉前(T0)、手术开始60min(T1)、术毕(T2)、术后12h(T3)、术后24h(T4)时采集静脉血样,测定白细胞介素(IL)-2和(IL)-6浓度,同时观察MAP、HR的变化。结果两组患者IL-2、IL-6浓度均呈升高趋势。T1、T2时刻SA组IL-2、IL-6浓度低于GA组,差异有统计学意义(P<0.05);两组患者MAP、HR呈不同的变化趋势。SA组中T1、T2时刻MAP、HR均低于基础值(T0),GA组中T1、T2时刻MAP、HR均高于基础值(T0);SA组中T1、T2时刻MAP、HR均低于GA组,差异有统计学意义(P<0.05)。结论超声引导下前锯肌平面阻滞复合全麻可以减轻乳腺癌改良根治术炎性反应,而且较单纯全麻血流动力学稳定。Objective To investigate the effect of ultrasound guided serratus anterior block combined with general anesthesia on the inflammatory response and hemodynamics of modified radical mastectomy for breast cancer. Methods Forty patients with modified radical mastectomy, aged 35-68 years, weighing 52-78 kg, ASA Ⅰ-Ⅱ, were randomly divided into two groups, under ultrasound guid. ed serratus anterior block (group SA) and general anesthesia group (group GA), with 20 cases in each group. Group SA had a serratus anterior block of ultrasound guided. Venous blood samples were collected before anesthesia (T0), 60 min (T1), operation (T2), 12 h (T3) after operation, and 24 h (T4) after operation, and the concentrations of interleukin (IL)-2 and 6 were measured. Meanwhile, the changes of MAP and HR were observed. Results The concentrations of IL-2 and IL-6 in the two groups showed an upward trend. At the time of T1 and T2, the concentration of IL-2 and IL-6 in group SA was lower than that in GA group, the difference was statistically significant ( P<0.05);MAP and HR showed different trends in two groups. In group SA, T1 and T2 times MAP and HR were lower than basic values (T0). T1 and T2 moments in GA group were higher than those of basic values (T0). In group SA, T1 and T2 time MAP and HR were all lower than those in GA group, the difference was statistically significant ( P<0.05). Conclusion The combined general anesthesia with ultra. sound guided serratus anterior block can reduce the inflammatory response of modified radical mastectomy, and the hemodynamic sta. bility is more stable than that of simple general anesthesia.

关 键 词：前锯肌平面阻滞 炎性反应 血流动力学 乳腺癌改良根治 

分 类 号：R737.9[医药卫生—肿瘤]