[1]蒋 敢,王 军,王会东△.舒芬太尼联合罗哌卡因肋间神经阻滞对乳腺癌患者术后镇痛、免疫功能及应激反应的影响*[J].陕西医学杂志,2019,(8):1077-1079,1084.
　JIANG Gan,WANG Jun,WANG Huidong..Effect of sufentanil plus ropivacaine intercostal nerve block on postoperative analgesia, immunity and stress response in patients with breast cancer[J].,2019,(8):1077-1079,1084.
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舒芬太尼联合罗哌卡因肋间神经阻滞对乳腺癌患者术后镇痛、免疫功能及应激反应的影响*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年8期
页码:
1077-1079,1084
栏目:
药物与临床
出版日期:
2019-08-05

文章信息/Info

Title:
Effect of sufentanil plus ropivacaine intercostal nerve block on postoperative analgesia, immunity and stress response in patients with breast cancer
文章编号:
DOI:10.3969/j.issn.1000-7377.2019.08.033
作者:
蒋 敢1; 王 军1; 王会东2△
1.武警陕西省总队医院麻醉科（西安 710054）；2.西安市第一医院（西安 710002）
Author(s):
JIANG Gan; WANG Jun; WANG Huidong.
Department of Anesthesiology, Shaanxi Armed Police Corps Hospital（Xi’an 710054）
关键词:
舒芬太尼; 罗哌卡因; 肋间神经阻滞; 乳腺癌; 镇痛;  应激反应; 免疫功能
Keywords:
Key words Sufentanil;  Ropivacaine; Intercostal nerve block;  Breast cancer;  Analgesia; Stress reaction; Immune function
分类号:
R614.4
文献标志码:
A
摘要:
摘 要 目的：探讨舒芬太尼联合罗哌卡因肋间神经阻滞在乳腺癌术后镇痛中的作用。方法:选取实施乳腺癌根治手术治疗的110例患者，采用随机数字表法分为试验组和对照组各55例，试验组采用舒芬太尼联合罗哌卡因肋间神经阻滞镇痛，对照组采用罗哌卡因肋间神经阻滞镇痛；对比两组患者术后疼痛程度（VAS评分）、Ramsay镇静评分、血清儿茶酚胺（CA）、皮质醇（CORT）、β-内酚酞、肾上腺素（E）、外周血T淋巴细胞亚群水平。结果：术后1 h，两组VAS评分差异无统计学意义（P>0.05）；术后4、8、12 h，试验组的VAS评分显著低于对照组（P＜0.05）；术后1 h，两组Ramsay镇静评分差异无统计学意义（P>0.05）；术后4、8 h，试验组Ramsay镇静评分显著高于对照组（P＜0.05）；术后1 h，两组血清CA、CORT、β-内酚酞、E差异无统计学意义（P>0.05）；术后4、8 h，试验组血清CA、CORT、β-内酚酞、E显著低于对照组（P＜0.05）；术后1 h，两组CD3+、CD4+、CD4+/CD8+差异无统计学意义（P>0.05）；术后4、8 h，试验组的CD3+、CD4+、CD4+/CD8+显著的高于对照组（P＜0.05）。结论：舒芬太尼联合罗哌卡因肋间神经阻滞在乳腺癌术后镇痛中较单用罗哌卡因具有更好的效果，可减轻手术创伤引起的术后应激反应及对免疫功能的损伤。
Abstract:
Abstract Objective :To investigate the effect of sufentanil plus ropivacaine intercostal nerve block on postoperative analgesia in patients with breast cancer. Methods:110 patients with breast cancer undergoing radical surgery were randomly divided into experimental group and control group with 55 cases in each group. Sufentanil + ropivacaine intercostal nerve block analgesia was used in experimental group, while ropivacaine intercostal nerve block analgesia was used in control group. Pain severity, Ramsay sedation score, serum catecholamine (CA), cortisol (CORT), beta-phenolphthalein, epinephrine (E), peripheral blood T lymphocytes. Results：One hour after operation, there was no significant difference in VAS score between the experimental group and the control group (P>0.05); 4 hours, 8 hours, 12 hours after operation, the VAS score of the experimental group was significantly lower than that of the control group (P＜0.05); 1 hour after operation, Ramsay sedation score of the experimental group and the control group had no significant difference (P> 0.05); 4 hours, 8 hours after operation, Ra sedation score of the experimental group was significantly lower than that of the control group (P>0.05). MSay sedation score was significantly higher than that of the control group (P＜0.05); 1 hour after operation, serum CA, CORT, beta-lactophthalein, E in the experimental group and the control group had no significant difference (P>0.05); 4 hours and 8 hours after operation, serum CA, CORT, beta-lactophthalein, E in the experimental group were significantly lower than that in the control group (P<0.05); 1 hour after operation, serum CA, CORT, beta-lactophthalein and E were significantly lower than that in the control group. There was no significant difference in CD3+,CD4+,CD4+/CD8+ between the two groups (P>0.05), and the levels of CD3+,CD4+,CD4+/CD8+ in the experimental group were significantly higher than those in the control group (P< 0.05). Conclusion:Sufentanil plus ropivacaine〖LM〗 intercostal nerve block is more effective than ropivacaine alone in postoperative analgesia of breast cancer, and can alleviate the postoperative stress reaction and immune function damage of patients with surgical trauma.

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备注/Memo

备注/Memo:
*国家自然科学基金资助青年科学基金项目(81400662)
更新日期/Last Update: 2019-08-13