|本期目录/Table of Contents|

[1]陈俊太,吕国义.胸椎旁神经阻滞复合全身麻醉对乳腺癌手术炎性反应的影响[J].天津医科大学学报,2016,22(04):332-335.
 CHEN Jun-tai,LV Guo-yi.Effects of thoracic paravertebral block combined with general anesthesia on inflammatory reaction in breast cancer surgery[J].Journal of Tianjin Medical University,2016,22(04):332-335.
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胸椎旁神经阻滞复合全身麻醉对乳腺癌手术炎性反应的影响

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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
22卷
期数:
2016年04期
页码:
332-335
栏目:
临床医学
出版日期:
2016-07-19

文章信息/Info

Title:
Effects of thoracic paravertebral block combined with general anesthesia on inflammatory reaction in breast cancer surgery
文章编号:
1006-8147(2016)04-0332-04
作者:
陈俊太12吕国义1

(1. 天津医科大学第二医院麻醉科,天津300211;2. 天津市第四中心医院麻醉科, 天津300140)

Author(s):

CHEN Jun-tai13 LV Guo-yi2

?(1.?Department of Anesthesiology, The Second Hospital , Tianjin Medical University , Tianjin 300211, China; 2. Department of Anesthesiology , Tianjin Fourth Central Hospital, Tianjin 300140, China)
关键词:
胸椎旁阻滞麻醉炎症反应乳腺癌改良根治术
Keywords:
thoracic paravertebral blockanesthesia inflammatory reaction modified radical mastectomy of breast cancer
分类号:
R614
DOI:
-
文献标志码:
A
摘要:
目的:探讨超声引导下胸椎旁神经阻滞复合全麻对乳腺癌改良根治术患者炎性反应的影响。方法:连续48例接受乳腺癌改良根治术患者被随机分配到全凭静脉全身麻醉组(GA组)或胸椎旁神经阻滞复合全凭静脉麻醉组(PG组)。PG组在超声引导下于T4间隙行TPVB;分别于麻醉前(T0)、手术开始30 min(T1)、术毕(T2)、术后8h(T3)时采集静脉血样,测定IL-6和IL-10的浓度,同时观察HR和MAP的变化。结果:与T0时比较,两组患者在T2和T3时刻,IL-6和IL-10表达均明显升高(p<0.05);与GA组比较,PG组IL-6表达水平更低(P<0.05),而IL-10表达水平则更高(P<0.05)。结论:胸椎旁神经阻滞复合全身麻醉用于乳腺癌改良根治术患者时,可以一定程度上抑制炎性因子的释放。
Abstract:
Objective: To investigate inflammatory reaction in patients undergoing breast cancer surgery by ultrasound-guided thoracic paravertebral block (TPVB) combined with general anesthesia. Methods: After local ethics committee approval, 48 consecutive patients undergoing breast cancer surgery were randomized into the GA or the PG group. TPVB guided by ultrasound was applied on PG group patients; blood samples were collected at preanesthetic (T0),30 mins after surgery started (T1),when surgery was completed (T2) and postoperative 8h (T3). Serum interleukin-6(IL-6) and IL-10 were determined by ELISA while the changes of HR and MAP were observed. Results: Compared with T0, IL-6 and IL-10 expressions of patients in T2 and T3, were significantly increased (P<0.05); compared with the GA group, expression of IL-6 levels of PG group were significantly lower (P <0.05), while IL-10 expression levels were higher (P<0.05). Conclusion: TPVB can reduce inflammatory reaction in patients undergoing breast cancer surgery.

参考文献/References:

[1]Wang X J, Yuan S L, Lu Y R, et al. Growth inhibition of high-intensity focused ultrasound on hepatic cancer in vivo[J]. World J Gastroenterol, 2005, 11(28): 4317

[2]Viscusi E R. Patient-controlled drug delivery for acute postoperative pain management: a review of current and emerging technologies[J]. Reg Anesth Pain Med, 2008, 33(2): 146

[3]赵达强,朱晓岚,赵霖霖,等.喉罩全身麻醉复合超声引导下胸椎旁神经阻滞在乳腺癌根治术的麻醉及术后镇痛中的应用[J].上海医学,2011,34(6):424

[4]何建华,马曙亮,顾连兵.超声引导椎旁神经阻滞在开胸手术中的应用[J].临床麻醉学杂志,2013,29(1):31

[5]Renes S H, Bruhn J, Gielen M J, et al. In-plane ultrasound-guided thoracic paravertebral block: a preliminary report of 36 cases with radiologic confirmation of catheter position[J]. Reg Anesth Pain Med, 2010, 35(2): 212

[6]Cheema S, Richardson J, Mcgurgan P. Factors affecting the spread of bupivacaine in the adult thoracic paravertebral space[J]. Anaesthesia, 2003, 58(7): 684

[7]Moore D L, Ding L L, Sadhasivam S. Novel real-time feedback and integrated simulation model for teaching and evaluating ultrasound-guided regional anesthesia skills in pediatric anesthesia trainees[J]. Paediatr Anaesth, 2012, 22(9): 847

[8]Farjad Sultan S, Shorten G, Iohom G. Simulators for training in ultrasound guided procedures[J]. Med Ultrason, 2013, 15(2): 125

[9]Zhang Y, Yu C F, Liu J S, et al. Training for percutaneous renal access on a virtual reality simulator[J]. Chin Med J (Engl), 2013, 126(8): 1528

[10]Luyet C, Eichenberger U, Greif R, et al. Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study[J]. Br J Anaesth, 2009, 102(4): 534

[11]Schnabel A, Reichl S U, Kranke P, et al. Efficacy and safety of paravertebral blocks in breast surgery: a meta-analysis of randomized controlled trials[J]. Br J Anaesth, 2010, 105(6): 842

[12]宋吉贵,招伟贤,胡彬,等.胸椎旁间隙阻滞在开胸手术中的应用[J].第一军医大学学报,2001,21(1):34

[13]宋金玲,孙立新,王明山.椎旁神经阻滞或硬膜外阻滞复合全麻对开胸手术炎性反应的影响[J].临床麻醉学杂志,2013,29(5):472

[14]Bhatia M, Moochhala S. Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome[J]. J Pathol, 2004, 202(2): 145

[15]邢翠燕,吴明毅,范海鹏.不同麻醉和镇痛方法对食管癌手术患者细胞免疫功能及应激激素水平的影响[J].南方医科大学学报,2010,30(2):284

[16]祝娟,冯艺,何苗,等.胸腔镜肺叶切除术后病人胸椎旁阻滞的镇痛效果[J].中华麻醉学杂志,2010,30(6):694

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备注/Memo

备注/Memo:
作者简介 陈俊太(1980-),男,主治医师,硕士在读,研究方向:临床麻醉学;通信作者:吕国义, E-mail:chenest1980@163.com
更新日期/Last Update: 2016-07-13