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目的探讨地佐辛超前镇痛对乳腺癌改良根治术患者炎症介质及应激反应的影响。方法选取2016年1月至12月间广州医科大学附属肿瘤医院收治的160例行乳腺癌改良根治术患者,采用随机数字表法分为研究组与对照组,每组80例。研究组患者于麻醉诱导前注入地佐辛5mg给予超前镇痛,对照组应用等容量氯化钠注射液。比较两组患者输液量、术中失血量、手术时间和麻醉前30min、术后2h、术后10h、术后24h及术后48h炎症介质与应激指标的变化。结果两组患者输液量、术中失血量和手术时间对比,差异均无统计学意义(均P>0.05)。两组患者术后2h、10h、24h及48h时白细胞介素-6(IL-6)和白细胞介素-10(IL-10)水平均高于麻醉前30min,且研究组均低于对照组,差异均有统计学意义(均P<0.05)。两组患者术后10h和24h时醛固酮、肾素、皮质醇与血管紧张素Ⅱ均高于麻醉前30min,且研究组均低于对照组,差异均有统计学意义(均P<0.05)。结论地佐辛超前镇痛可以有效抑制乳腺癌改良根治术患者的炎症介质,降低应激反应,有效保证了预后质量。
Objective To investigate the effect of dezocine in advance on the inflammatory mediators and stress response in patients with modified radical mastectomy. Methods A total of 160 patients undergoing modified radical mastectomy from January 2016 to December 2016 in Cancer Hospital of Guangzhou Medical University were divided into study group and control group with 80 cases in each group. Patients in the study group were given preemptive analgesia with dezocine 5 mg before induction of anesthesia, and equal volume sodium chloride injection in the control group. The changes of inflammatory mediators and stress indexes were compared between the two groups in terms of infusion volume, intraoperative blood loss, operation time and 30 min before anesthesia, 2 h after operation, 10 h after operation, 24 h after operation and 48 h after operation. Results There was no significant difference between the two groups in the amount of fluid transfusion, intraoperative blood loss and operation time (all P> 0.05). The levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) at 2h, 10h, 24h and 48h after operation in both groups were significantly higher than those before anesthesia , The differences were statistically significant (all P <0.05). The levels of aldosterone, renin, cortisol and angiotensin Ⅱ in the two groups were significantly higher than those in the control group at 10 and 24 hours after operation, and the differences between the two groups were statistically significant (all P <0.05). Conclusion Dezocine preemptive analgesia can effectively inhibit the inflammatory mediators in patients with modified radical mastectomy and reduce the stress response, effectively ensuring the quality of prognosis.