国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
12期
816-820
,共5页
王世英%魏光武%毕光焰%肖骏
王世英%魏光武%畢光燄%肖駿
왕세영%위광무%필광염%초준
地佐辛%芬太尼%乳腺肿瘤%静脉镇痛%镇痛
地佐辛%芬太尼%乳腺腫瘤%靜脈鎮痛%鎮痛
지좌신%분태니%유선종류%정맥진통%진통
Dezocine%Fentanyl%Breast neoplasms%Intravenous analgesia%Analgesia
目的 探讨地佐辛联合芬太尼在乳腺癌术后自控静脉镇痛中的意义.方法 选择美国麻醉协会分级Ⅰ～Ⅲ级行乳腺癌手术治疗的患者126例,均采用气管插管复合静脉麻醉,术后行自控静脉镇痛.患者按均衡随机分组的方法分为对照组和研究组,对照组(63例)术后仅行芬太尼静脉镇痛,研究组(63例)术后采用地佐辛联合芬太尼静脉镇痛.观察两组患者术后12、24及48 h的疼痛评分、镇静评分和舒适度评分.并比较两组患者术后自控静脉镇痛的不良反应发病率.分别于术前1天和术后第1天、第7天观察患者T细胞亚群和IL-2水平的变化.结果 在各时间点,研究组视觉模拟评分明显低于对照组,镇静效果评分明显高于对照组(P＜0.05).两组舒适度评分差异无统计学意义(P＞0.05).对照组和研究组不良反应发病率差异无统计学意义(P＞0.05).术前1天、术后第1天,研究组与对照组CD4+、CD8+T细胞、CD4+/CD8+、IL-2比较差异均无统计学意义(P＞0.05).术后第7天,对照组CD4+、CD4+/CD8+、IL-2分别为(45.68±5.82)％、(1.45±0.25)、(1.51±0.37)μg/L,研究组CD4+、CD4+/CD8+、IL-2分别为(52.35±6.34)％、(1.82±0.31)、(1.75±0.48)μg/L,与对照组比较,研究组CD4+、CD4+/CD8+、IL-2明显升高(P＜0.05);而对照组和研究组CD8+T细胞比例分别为(26.25 ±3.37)％、(21.23±2.78)％,二者之间差异有统计学意义(P＜0.05).结论 地佐辛联合芬太尼用于乳腺癌术后自控静脉镇痛可以提高静脉镇痛的效果,减少静脉镇痛的不良反应,对患者术后免疫功能的改善也有积极的作用.
目的 探討地佐辛聯閤芬太尼在乳腺癌術後自控靜脈鎮痛中的意義.方法 選擇美國痳醉協會分級Ⅰ～Ⅲ級行乳腺癌手術治療的患者126例,均採用氣管插管複閤靜脈痳醉,術後行自控靜脈鎮痛.患者按均衡隨機分組的方法分為對照組和研究組,對照組(63例)術後僅行芬太尼靜脈鎮痛,研究組(63例)術後採用地佐辛聯閤芬太尼靜脈鎮痛.觀察兩組患者術後12、24及48 h的疼痛評分、鎮靜評分和舒適度評分.併比較兩組患者術後自控靜脈鎮痛的不良反應髮病率.分彆于術前1天和術後第1天、第7天觀察患者T細胞亞群和IL-2水平的變化.結果 在各時間點,研究組視覺模擬評分明顯低于對照組,鎮靜效果評分明顯高于對照組(P＜0.05).兩組舒適度評分差異無統計學意義(P＞0.05).對照組和研究組不良反應髮病率差異無統計學意義(P＞0.05).術前1天、術後第1天,研究組與對照組CD4+、CD8+T細胞、CD4+/CD8+、IL-2比較差異均無統計學意義(P＞0.05).術後第7天,對照組CD4+、CD4+/CD8+、IL-2分彆為(45.68±5.82)％、(1.45±0.25)、(1.51±0.37)μg/L,研究組CD4+、CD4+/CD8+、IL-2分彆為(52.35±6.34)％、(1.82±0.31)、(1.75±0.48)μg/L,與對照組比較,研究組CD4+、CD4+/CD8+、IL-2明顯升高(P＜0.05);而對照組和研究組CD8+T細胞比例分彆為(26.25 ±3.37)％、(21.23±2.78)％,二者之間差異有統計學意義(P＜0.05).結論 地佐辛聯閤芬太尼用于乳腺癌術後自控靜脈鎮痛可以提高靜脈鎮痛的效果,減少靜脈鎮痛的不良反應,對患者術後免疫功能的改善也有積極的作用.
목적 탐토지좌신연합분태니재유선암술후자공정맥진통중적의의.방법 선택미국마취협회분급Ⅰ～Ⅲ급행유선암수술치료적환자126례,균채용기관삽관복합정맥마취,술후행자공정맥진통.환자안균형수궤분조적방법분위대조조화연구조,대조조(63례)술후부행분태니정맥진통,연구조(63례)술후채용지좌신연합분태니정맥진통.관찰량조환자술후12、24급48 h적동통평분、진정평분화서괄도평분.병비교량조환자술후자공정맥진통적불량반응발병솔.분별우술전1천화술후제1천、제7천관찰환자T세포아군화IL-2수평적변화.결과 재각시간점,연구조시각모의평분명현저우대조조,진정효과평분명현고우대조조(P＜0.05).량조서괄도평분차이무통계학의의(P＞0.05).대조조화연구조불량반응발병솔차이무통계학의의(P＞0.05).술전1천、술후제1천,연구조여대조조CD4+、CD8+T세포、CD4+/CD8+、IL-2비교차이균무통계학의의(P＞0.05).술후제7천,대조조CD4+、CD4+/CD8+、IL-2분별위(45.68±5.82)％、(1.45±0.25)、(1.51±0.37)μg/L,연구조CD4+、CD4+/CD8+、IL-2분별위(52.35±6.34)％、(1.82±0.31)、(1.75±0.48)μg/L,여대조조비교,연구조CD4+、CD4+/CD8+、IL-2명현승고(P＜0.05);이대조조화연구조CD8+T세포비례분별위(26.25 ±3.37)％、(21.23±2.78)％,이자지간차이유통계학의의(P＜0.05).결론 지좌신연합분태니용우유선암술후자공정맥진통가이제고정맥진통적효과,감소정맥진통적불량반응,대환자술후면역공능적개선야유적겁적작용.
Objective To investigate the significance of Dezocine combining Fentanyl used for postoperative PCIA in breast cancer patients.Methods One hundred and twenty six patients with ASA Ⅰ-Ⅲ entered the study.All patients were scheduled for breast cancer operation under intravenous analgesia with tube insertion and treated with PCIA after the operation.They were randomly divided into Fentanyl group (n =63) and Dezocine combining Fentanyl group(n =63).VAS,Ramsay,BCS in two groups were compared al 12 h,24 h,48 h after operation.Side effect was also detected.The changes of T cell subset and IL-2 were analyzed in the patients respectively at the first day before operation,at the first day after operation,at the seventh day after operation.Results At every time point,VAS in research group was significantly lower than that in control group(P ＜ 0.05).However,Ramsay in research group was obviously higher than that in control group(P ＜0,05).There were no significant differences in BCS between two groups (P ＞ 0.05).And no difference was found in the incidence of side effect between two groups (P ＞ 0.05).Compared with control group,the changes of T cell subset,IL-2 had no significant differences in research group at the first day after operation and at the first day before operation (P ＞ 0.05).At the seventh day after operation,the levels of CD4 +,CD4 +/CD8 +,IL-2 in research group were obviously higher than those in control group (P ＜ 0.05).However,the percentage of CD8 + T cells in research group was significantly lower than that in control group (P ＜ 0.05).Conclusions Dezocine combining Fentanyl in PCIA can increase analgesia effect with less side effect.It is positive to improve immunologic function for breast carcinoma patients after operation.
