吗啡混合布比卡因创面喷洒用于预防乳腺癌切除术后疼痛综合征的效果
发布时间：2018-12-28 13:50
【摘要】：目的探讨吗啡混合布比卡因创面喷洒用于预防乳腺癌切除术后疼痛综合征(PMPS)的效果及其对免疫功能的影响。方法择期行乳腺癌改良根治术的患者90例,采用随机数字表法随机分为对照组(C组)、布比卡因组(B组)和吗啡混合布比卡因组(MB组),每组30例,缝皮前即刻分别用盐水、布比卡因或吗啡/布比卡因混合液均匀喷洒于创面,保持药液在创面30 min后打开引流管。记录术后6、12、24和48 h静态和动态VAS、术后48 h内静脉自控镇痛(PCIA)药液消耗量、舒芬太尼的使用率和用量以及不良反应的发生情况,并于术前1 h和术后24 h抽取静脉血测定细胞因子白细胞介素(IL)-2、γ干扰素(INF-γ)和IL-10的浓度。术后1、3个月以利兹神经病理性疼痛症状与体征评价量表(LANSS)测定患者是否患有PMPS。结果与C组比较,B组各时点静态和动态VAS降低(P0.05);与B组比较,MB组各时点静态和动态VAS降低(P0.05)。与C组比较,B组PICA药液的消耗量、舒芬太尼的使用率和用量均降低(P0.05);与B组比较,MB组PICA药液的消耗量、舒芬太尼的使用率和用量均降低(P0.05)。3组间不良反应的发生率差异无统计学意义(P0.05)。与C组比较,B组术后1、3个月的LANSS评分和PMPS发生率均降低(P0.05);与B组比较,MB组术后1、3个月的LANSS评分和PMPS发生率均降低(P0.05)。3组间手术前后血清细胞因子的浓度差异无统计学意义(P0.05)。结论吗啡混合布比卡因创面喷洒可减少PMPS的发生,且对免疫功能无影响。
[Abstract]:Objective to investigate the effect of morphine combined bupivacaine spray on the prevention of postoperative pain syndrome (PMPS) after breast cancer resection and its effect on immune function. Methods 90 patients with breast cancer undergoing modified radical mastectomy were randomly divided into control group (group C), bupivacaine group (group B) and morphine mixed bupivacaine group (MB group). Immediately before suture, brine, bupivacaine or morphine / bupivacaine were sprayed evenly on the wound, and the drainage tube was opened after 30 min. The consumption of intravenous analgesic (PCIA), the usage and dosage of sufentanil and the occurrence of adverse reactions were recorded at 24 and 48 hours after operation by static and dynamic VAS,. The concentrations of cytokines interleukin (IL) 2, interferon 纬 (INF- 纬) and IL-10 were measured 1 hour before operation and 24 hours after operation. 1 and 3 months after operation, PMPS. was measured with the Leeds Neuropathic pain Evaluation scale (LANSS). Results compared with group C, the static and dynamic VAS of group B was lower than that of group C (P0.05), and the static and dynamic VAS of group MB was lower than that of group B (P0.05). Compared with group C, the consumption of PICA, the utilization rate and dosage of sufentanil in group B were decreased (P0.05). Compared with group B, the consumption of PICA, the usage and dosage of sufentanil in MB group were decreased (P0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P0.05). Compared with group C, the LANSS score and the incidence of PMPS in group B were significantly lower than those in group C 1 and 3 months after operation (P0.05). Compared with group B, the LANSS score and the incidence of PMPS decreased in MB group 1 and 3 months after operation (P0.05). There was no significant difference in serum cytokine levels between the three groups before and after operation (P0.05). Conclusion morphine combined with bupivacaine can reduce the incidence of PMPS and has no effect on immune function.
【作者单位】： 河北医科大学第三医院麻醉科;哈励逊国际和平医院麻醉科;河北医科大学基础医学院法医系;
【分类号】：R614;R737.9
本文编号：2394031
[Abstract]:Objective to investigate the effect of morphine combined bupivacaine spray on the prevention of postoperative pain syndrome (PMPS) after breast cancer resection and its effect on immune function. Methods 90 patients with breast cancer undergoing modified radical mastectomy were randomly divided into control group (group C), bupivacaine group (group B) and morphine mixed bupivacaine group (MB group). Immediately before suture, brine, bupivacaine or morphine / bupivacaine were sprayed evenly on the wound, and the drainage tube was opened after 30 min. The consumption of intravenous analgesic (PCIA), the usage and dosage of sufentanil and the occurrence of adverse reactions were recorded at 24 and 48 hours after operation by static and dynamic VAS,. The concentrations of cytokines interleukin (IL) 2, interferon 纬 (INF- 纬) and IL-10 were measured 1 hour before operation and 24 hours after operation. 1 and 3 months after operation, PMPS. was measured with the Leeds Neuropathic pain Evaluation scale (LANSS). Results compared with group C, the static and dynamic VAS of group B was lower than that of group C (P0.05), and the static and dynamic VAS of group MB was lower than that of group B (P0.05). Compared with group C, the consumption of PICA, the utilization rate and dosage of sufentanil in group B were decreased (P0.05). Compared with group B, the consumption of PICA, the usage and dosage of sufentanil in MB group were decreased (P0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P0.05). Compared with group C, the LANSS score and the incidence of PMPS in group B were significantly lower than those in group C 1 and 3 months after operation (P0.05). Compared with group B, the LANSS score and the incidence of PMPS decreased in MB group 1 and 3 months after operation (P0.05). There was no significant difference in serum cytokine levels between the three groups before and after operation (P0.05). Conclusion morphine combined with bupivacaine can reduce the incidence of PMPS and has no effect on immune function.
【作者单位】： 河北医科大学第三医院麻醉科;哈励逊国际和平医院麻醉科;河北医科大学基础医学院法医系;
【分类号】：R614;R737.9
【相似文献】
相关期刊论文 前10条
1 武正炎;保留乳房的乳腺癌切除术[J];实用临床医药杂志;2003年02期
2 欧阳艳红;;乳腺癌切除术病理标本分析[J];中国当代医药;2010年05期
3 张培新;王学究;张允清;;保留乳房的乳腺癌切除术治疗早期乳腺癌[J];淮海医药;2013年04期
4 刘荫华，王文治，黄莛庭;保守性乳腺癌切除术治疗现状[J];普外临床;1996年02期
5 许元禄;张淑美;陈丽;徐继轶;;单侧胸部“Z”形皮瓣修复乳腺癌切除术后创面[J];中国社区医师(医学专业);2011年32期
6 周光荣;乳腺癌切除术后近期并发症及其防治354例分析[J];南京医科大学学报;2001年01期
7 陈树聪,李转清,郑龙娃,吴鹏程;乳腺癌切除术患者术前SCL-90测评分析[J];职业与健康;2002年11期
8 任华丁;叶惠雅;王对对;;乳腺癌切除术中应用福爱乐医用胶的体会[J];中国药物与临床;2009年S1期
9 武正炎;;谈保留乳房的乳腺癌切除术[J];外科理论与实践;2006年02期
10 ;[J];;年期
，本文编号：2394031
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2394031.html
最近更新
教材专著
