CAJ | 학술논문

目的：应激状态下血浆内皮素( Endothelin；ET)是损伤胃黏膜的重要致病因子。痛会引起强烈的应激反应，通过检测胃癌术后病人外周血中ET-1水平，从而探讨有效术后镇痛对胃癌病人术后血浆ET-1有何影响。方法：50例ASAI级或II级择期行胃癌根治术病人，随机均分为两组：镇痛组与对照组(未行镇痛组)，各25例，记录术后6 h、12 h、24 h静息疼痛视觉模拟评分( VAS)和Ram-Say镇静评分及术后肛门排气时间、拔胃管时间、进食流质时间。分别于术前、术后6、12 h采外周血应用放射免疫法检测血浆ET-1的水平。结果：镇痛组与对照组两组病人术前ET-1水平无显著差异，而在术后6 h与术后12 h的时间点上两组血浆ET-1水平均有有明显差异(P<0.05)，镇痛组术后ET-1水平明显低于对照组。各组内不同时间点指标比较：对照组ET-1水平在各时间点均有明显差异(P<0.05)，术后6 h ET-1水平最高，术后12 h ET-1水平次之，但都高于术前；镇痛组在不同时间点的ET-1水平均无明显差异。结论：有效的术后镇痛可抑制血浆ET-1水平升高，从而降低由ET-1对胃黏膜的损伤，术后镇痛对胃癌根治术病人术后恢复是有益的。
목적：응격상태하혈장내피소( Endothelin；ET)시손상위점막적중요치병인자。통회인기강렬적응격반응，통과검측위암술후병인외주혈중ET-1수평，종이탐토유효술후진통대위암병인술후혈장ET-1유하영향。방법：50례ASAI급혹II급택기행위암근치술병인，수궤균분위량조：진통조여대조조(미행진통조)，각25례，기록술후6 h、12 h、24 h정식동통시각모의평분( VAS)화Ram-Say진정평분급술후항문배기시간、발위관시간、진식류질시간。분별우술전、술후6、12 h채외주혈응용방사면역법검측혈장ET-1적수평。결과：진통조여대조조량조병인술전ET-1수평무현저차이，이재술후6 h여술후12 h적시간점상량조혈장ET-1수평균유유명현차이(P<0.05)，진통조술후ET-1수평명현저우대조조。각조내불동시간점지표비교：대조조ET-1수평재각시간점균유명현차이(P<0.05)，술후6 h ET-1수평최고，술후12 h ET-1수평차지，단도고우술전；진통조재불동시간점적ET-1수평균무명현차이。결론：유효적술후진통가억제혈장ET-1수평승고，종이강저유ET-1대위점막적손상，술후진통대위암근치술병인술후회복시유익적。
Objective:Under stress ( Endothelin;ET) is an important pathogenic factor of gastric mucosal injury. Pain may cause a strong stress response, by detecting the peripheral blood of gastric carcinoma patients plasma endothelin-1(ET-1)levels. To explore effective postoperative analgesia on postoperative gastric carcinoma patients plasma ET-1 impact. Methods:50 cases of ASAI or II grade elective resection of gastric carcinoma patients were randomly divided into two groups:Analgesia group and the control group(no analgesia group)of the 25 cases. Record after 6 h,12 h,24 h resting pain visual analogue scale( VAS) and Ram-Say sedation and postoperative anal exhaust time,pulling tube time,eating liquid time,Respectively,before operation 6 h、after 12 h blood detecting sample of plasma ET-1 levels by radioimmunoassay. Results:Two groups of patients before operation no difference at ET -1 levels,In the postoperative time of 6 h and 12 h ET-1 levels are significantly different(P<0. 05), ET-1 analgesia group were significantly lower than the control group. Through the different time points within the each group Comparative, the control group of ET-1 levels at each time point were significantly different(P<0. 05),Postoperative 6 h ET-1 levels the highest,Postoperative 12 h ET-1 was second,but higher than preoperative,Analgesia group at different time points of ET-1 levels were not significantly different. Conclusion:Effective postoperative analgesia can inhibit plasma levels of ET-1, Reducing gastric mucosal injury. This research found that patients of gastric carcinoma postoperative radical operation recovery of gastrointestinal function are useful.