中国冶金工业医学杂志

同麻醉及镇痛方法对乳腺癌手术患者细胞应激反应相关激素水平的影响

单位：1.内蒙古大学生命科学院内蒙古呼和浩特 010010 2.内蒙古医科大学第三附属医院

分类号：R 614

出版年,卷(期):页码：2014,31(4):381-383

摘要：

摘要：目的探讨两种麻醉方法在围术期对乳腺癌根治术患者血清相关应激激素水平的影响。方法将80例乳腺癌患者按麻醉方法不同分为A、B两组各40例。A组采用硬膜外阻滞复合静脉全麻、B组采用全凭静脉麻醉，术后两组患者均行自控静脉镇痛。分别于麻醉前30 min(T0)、切皮后1 h(T1)、术后4 h(T2)、24 h(T3)和48 h(T4)等5个时点检测患者血清PRL、GH、IL\|8和IFN\|γ浓度，观察不同麻醉方法及术后镇痛方式对恶性肿瘤患者围麻醉期相关应激激素水平的影响。结果（1）两组患者血清PRL含量均随手术进程缓慢升高，且在T1时达到高峰，然后逐渐下降，各时点间PRL含量比较差异有统计学意义（P＜0.05）。其中B组患者血清PRL含量在T1时显著高于A组（P＜0.05）。（2）两组患者血清GH含量亦随手术进程缓慢升高，且在T2时达到高峰，然后又逐渐下降；其中A组患者血清GH含量在T1、T2时达高峰，而在各时点B组患者血清GH含量均高于A组。（3）两组患者血清IL\|8含量在T1、T2、T3和T4时点均小于T0（P＜0.05）,且A组患者血清IL\|8含量均小于B组（P＜0.05）。（4）两组患者血清中IFN\|γ的含量均随着手术进程缓慢升高，均在T3、T4时点达高峰。结论用硬膜外阻滞复合静脉全麻能够更好的抑制乳腺癌根治术中的患者应激反应。

Abstract:ObjectiveTo observe the effect of the cell stress response related hormone level of PRL,IL\|8,GH and IFN\|γ before and after the surgery by controlled patient\|controlled venous analgesia with simplegeneral anesthesia and controlled vein analgesia line breast cancer.MethodsSelect elective modified radical mastectomy surgery patients,80 cases were randomly divided into two groups：group A with epidural block compound vein anesthesia and group B with intravenous anesthesia.Two groups of postoperative patients were lines of self\|control vein analgesia.In 30 min before anesthesia(T0),cut skin after 1 h(T1),postoperative 4 h(T2),24 h(T3)and 48 h(T4),five point detection in patients with serum PRL and GH,IL\|8 and IFN\|γ density.ELISA kit was adopted to detect the hormone levels changes of stress response.Results(1)Two groups of patients serum PRL levels were increased slowly with the process of operation.And reached peak at T1,then gradually declined.PRL levels in each point were significantly different(P＜0.05).And PRL levels in group B was significantly higher than group A(P＜0.05).(2)Two groups of patients serum GH levels also increased with the process of surgery,and reached peak at T2,then gradually declined.In group A,GH levels at T1 and T2 was higher than T0,T3 and T4(P＜0.05).In group B,GH levels at T2 and T3 was higher than T0,T1 and T4(P＜0.05).GH levels in group B was higher than group A.(3)IL\|8 levels in A group was highest at T0(P＜0.05).IL\|8 levels in group A were less than group B(P＜0.05).(4)Two groups of patients serum IFN\|γ levels increased with the process of surgery,and reached its peak at T3 and T4.ConclusionGeneral anesthesia combined with epidural anesthesia inhibited stress reaction was better than intravenous anesthesia in modified radical mastectomy.

基金项目：

作者简介：

参考文献：

参考文献［1］曹旭晨,赵凯,宁连胜.乳腺癌患者术中保留肋间臂神经的临床意义\[J\].中华肿瘤杂志,2006,28(7):549\|550.
［2］江泽飞,宋三泰.乳腺癌内分泌治疗的新思路和新策略\[J\].中华肿瘤杂志,2003,25(04):410\|411.
［3］Elkhodary TR,MA Ebrahim,EE Hatataand NA Niazy.Prognostic value of lymph node ratio in node\|positive breast cancer in Egyptian patients\[J\].J Egypt Natl Canc Inst,2014,26(1):31\|35.

服务与反馈：

【文章下载】【加入收藏】