CAJ | 학술논문

目的探讨氟比洛芬酯超前镇痛对乳腺癌患者术后患者血糖及白细胞介素6(IL-6)水平的影响,并评价其镇痛效果.方法拟行乳腺癌根治术患者60例,随机分为3组:超前镇痛组(A组)、空白对照组(B组)和术后镇痛对照组(C组),每组各20例,分别在麻醉诱导前或术毕时对A、C组患者缓慢静脉注射氟比洛芬酯100 mg.于麻醉诱导前及术后1、6、24 h采血,检测血糖和血清IL-6水平,并采用视觉模拟评分法(VAS)进行疼痛评分.结果 3组患者术后各时点血糖和血清IL-6水平显著高于术前(P<0.01),B组术后1、6和24 h逐渐升高,术后24 h水平与术后1 h相比,差异具有极显著性意义(P<0.01),A、C两组则无明显升高趋势.组间比较:A组也即超前镇痛组术后各时点血糖和IL-6水平明显低于B组和C组(P<0.01或0.05).术后24 h内患者最高VAS评分A、C组显著低于B组(P<0.05).结论乳腺癌根治术前应用氟比洛芬酯超前镇痛可取得确切、安全的镇痛效果,并能有效抑制术后血糖和IL-6水平升高,调控机体的应激和炎症反应.
목적 탐토불비락분지초전진통대유선암환자술후환자혈당급백세포개소6(IL-6)수평적영향,병평개기진통효과.방법 의행유선암근치술환자60례,수궤분위3조:초전진통조(A조)、공백대조조(B조)화술후진통대조조(C조),매조각20례,분별재마취유도전혹술필시대A、C조환자완만정맥주사불비락분지100 mg.우마취유도전급술후1、6、24 h채혈,검측혈당화혈청IL-6수평,병채용시각모의평분법(VAS)진행동통평분.결과 3조환자술후각시점혈당화혈청IL-6수평현저고우술전(P<0.01),B조술후1、6화24 h축점승고,술후24 h수평여술후1 h상비,차이구유겁현저성의의(P<0.01),A、C량조칙무명현승고추세.조간비교:A조야즉초전진통조술후각시점혈당화IL-6수평명현저우B조화C조(P<0.01혹0.05).술후24 h내환자최고VAS평분A、C조현저저우B조(P<0.05).결론 유선암근치술전응용불비락분지초전진통가취득학절、안전적진통효과,병능유효억제술후혈당화IL-6수평승고,조공궤체적응격화염증반응.
Objective To investigate the effects of preemptive analgesia with flurbiprofen on the blood sugar and Interleukin-6 of patients after radical excision of breast cancer.Methods A total of 60 ASA Ⅰ-Ⅱpatients scheduled for radicul excision of breast cancer were randomly assigned to three groups:group A,B and C(n=20 each),patients of group A and C received intravenous flurbiprofen 100 mg before or at the end of surgery respectively.Blood samples were collected from the patients before anaesthesia induction and 1,6,24 h after surgery for the determination of blood sugar and serum interleukin-6 concentration.Analgesic efficacy was assessed after surgery based on visual analog scales(VAS).Results The blood sugar and serum interleukin-6 concertration of the patients in three groups at different time points after surgery were significantly higher than those before surgery,and increased gradually in group B,and there were very significant difference between the time point of 1 h and 24 h after surgery(P＜0.01),but there were no increasing trend for those of group A and C.The blood sugar and serunl interleukin-6 concentration of the patient of group A weresignificantly lower than those of group B and C(P＜0.01 or 0.05).The highest VAS of group A and C at different time points after surgery were significantly lower than that of group B(P＜0.05).Conclusion Preemptive analgesia with flurbiprofen 100 mg can effectively suppress the elevation of blood sugar and serum interleukin-6 concentration after radical excision of breast cancer,and is better than postoperation analgesia.