超声引导下前锯肌平面阻滞对乳腺癌根治术后疼痛程度及预后的影响

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摘要目的探讨超声引导下前锯肌平面阻滞对乳腺癌根治术后疼痛程度及预后的影响。方法选取2016年7月～2018年12月我院收治的50例乳腺癌根治术患者作为研究对象，采用随机数字表法将患者分为观察组（n=25）和对照组（n=25）。观察组患者行超声引导下前锯肌平面阻滞，对照组患者行常规麻醉。比较两组患者术后疼痛程度[数字评价量表（NRS）]、手术前后氧化应激分子[超氧化物歧化酶（SOD）、丙二醛（MDA）、髓过氧化酶（MPO）]及炎性因子[核因子-кB（NF-кB）、白介素-18（IL-18）、肿瘤坏死因子-α（TNF-α）]水平。结果观察组患者术后4、8 及24h 的NRS评分均低于对照组，差异有统计学意义（P＜0.05）。两组患者术前的SOD、MDA 及MPO 水平比较，差异无统计学意义（P＞0.05）；两组患者术后的SOD 水平均低于术前，MDA、MPO 水平均高于术前，差异有统计学意义（P＜0.05）；观察组患者术后的SOD 水平高于对照组，MDA、MPO 水平均低于对照组，差异有统计学意义（P＜0.05）。两组患者术前的IL-18、TNF-α、NF-кB 水平比较，差异无统计学意义（P＞0.05）；两组患者术后的IL-18、TNF-α、NF-кB 水平均高于术前，差异有统计学意义（P＜0.05）；观察组患者术后的IL-18、TNF-α、NF-кB 水平均低于对照组，差异有统计学意义（P＜0.05）。结论在乳腺癌根治术实施时采取超声引导下前锯肌平面阻滞，可有效缓解患者术后疼痛程度，减轻超氧化应激反应，减少患者的痛苦，对改善患者预后意义重大。

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	李智雄

关键词 ：乳腺癌根治术, 超声引导下前锯肌平面阻滞, 术后疼痛, 氧化应激, 效果

Abstract：Objective To investigate the effect of ultrasound-guided anterior serratus plane block on the degree of pain and prognosis after radical mastectomy for breast cancer.Methods A total of 50 undergoing radical mastectomy for breast cancer treated in our hospital from July 2016 to December 2018 were selected as the research subjects.The patients were divided into observation group(n=25)and control group(n=25)according to the random number table method.Patients in the observation group underwent ultrasound-guided anterior serratus plane block, and patients in the control group underwent routine anesthesia.The postoperative pain (numerical rating scale [NRS]), oxidative stress molecules(superoxide dismutase [SOD], malondialdehyde [MDA], myeloperoxidase [MPO]), and inflammatory factors (nuclear factor-кB [NF-кB], interleukin-18 [IL-18], tumor necrosis factor-α[TNF-α]) levels before and after surgery were compared in two groups of patients.Results The NRS scores of patients in the observation group at 4, 8 and 24 hours after surgery were lower than those in the control group, and the differences were statistically significant (P＜0.05).There were no significant differences in the levels of SOD, MDA and MPO before surgery between the two groups of patients(P＞0.05).The SOD levels of the two groups of patients after surgery were lower than those before surgery, and the levels of MDA and MPO were higher than those before surgery, the differences were statistically significant (P＜0.05).The SOD level after surgery in the observation group was higher than that in the control group, and the levels of MDA and MPO were lower than those in the control group, the differences were statistically significant (P＜0.05).There were no significant differences in the levels of IL-18, TNF-α, NF-кB before surgery between the two groups of patients (P＞0.05).The levels of IL-18, TNF-α, and NF-кB in the two groups after surgery were higher than those before surgery,and the differences were statistically significant (P＜0.05).The levels of IL-18, TNF-α, and NF-кB in the observation group after surgery were lower than those in the control group, and the differences were statistically significant(P＜0.05).Conclusion Ultrasound-guided anterior serratus plane block in the implementation of radical mastectomy for breast cancer can effectively relieve postoperative pain, reduce oxidative stress and reduce suffering of patients, which is of great significance for improving prognosis.

Key words： Radical mastectomy for breast cancer Ultrasound-guided anterior serratus plane block Postoperative pain Oxidative stress Effect

作者简介: 李智雄（1979-），本科，副主任医师，主要研究方向：超声引导下前锯肌平面阻滞术后镇痛

引用本文:

李智雄. 超声引导下前锯肌平面阻滞对乳腺癌根治术后疼痛程度及预后的影响[J]. 中国当代医药, 2020, 27(11): 149-152.
LI Zhi-xiong. Effect of ultrasound-guided anterior serratus plane block on the degree of pain and prognosis after radical mastectomy for breast cancer. 中国当代医药, 2020, 27(11): 149-152.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I11/149

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