超声引导前锯肌平面阻滞复合全麻对乳腺癌改良根治术患者围手术期免疫功能的影响
Effect of Ultrasound Guided Serratus Anterior Plane Block Combined with General Anesthesia on Perioperative Immune Function in Modified Radical Mastectomy for Breast Cancer Patients
徐勇民 1傅艳师 2王广珊 3彭娟 1赵慧磊1
作者信息
- 1. 南昌市第三医院麻醉科 江西 南昌 330009
- 2. 南昌市第三医院乳腺外科 江西 南昌 330009
- 3. 南昌市第三医院超声科 江西 南昌 330009
- 折叠
摘要
目的:探究超声引导前锯肌平面阻滞(SAPB)复合全麻对行乳腺癌改良根治术患者围手术期免疫功能的影响.方法:选取 2020 年 4 月—2022 年 7 月南昌市第三医院收治的 80 例行乳腺癌改良根治术(MRM)患者,随机分为对照组(n=40)、试验组(n=40).对照组在单纯全麻下手术,试验组在超声SAPB复合全麻下手术;于麻醉前 30 min(T0)、术中(T1)、术毕时(T2)时,比较两组炎症指标[白细胞介素(IL)-6、IL-8、肿瘤坏死因子-α(TNF-α)]、血清皮质醇(Cor);于术前、术后24 h,比较两组免疫功能(T淋巴细胞亚群);于术后 6、12、24、48 h,比较两组疼痛感[视觉模拟评分法(VAS)].结果:T1、T2 时,两组炎症、应激指标水平较T0 时逐渐上升,且试验组各时点IL-6、IL-8、TNF-α、Cor水平均低于对照组(P＜0.05).术后 24 h,两组CD4+均较术前显著下降,CD8+显著升高,但试验组CD4+高于对照组,CD8+低于对照组(P＜0.05).术后 6、12、24、48 h,两组VAS评分逐渐下降,且试验组均低于对照组(P＜0.05).结论:超声引导SAPB复合全麻应用于MRM患者中,能够减轻患者应激及炎症反应,缓解疼痛程度,且有一定免疫保护作用.
Abstract
Objective:To investigate the effect of ultrasound guided serratus anterior plane block(SAPB)combined with general anesthesia on immune function in the perioperative period of modified radical mastectomy for breast cancer patients.Method:A total of eighty patients with breast cancer undergoing modified radical mastectomy(MRM)from April 2020 to July 2022 in Nanchang Third Hospital were selected,were randomly divided into control group(n=40)and experimental group(n=40).The control group was operated under simple general anesthesia,and the experimental group was operated under ultrasound guided SAPB combined general anesthesia;at 30 min before anesthesia(T0),intraoperative(T1),and at the end of operation(T2),the inflammatory indicators[interleukin(IL)-6,IL-8,and tumor necrosis factor-α(TNF-α)],serum cortisol(Cor)of the two groups were compared;the immune function(T lymphocyte subsets)of the two groups were compared before and 24 h after operation;at 6,12,24 and 48 h after operation,the pain sensation[visual analogue scale(VAS)]of the two groups was compared.Result:At T1 and T2,the levels of inflammation and stress indicators in the two groups were gradually increased compared with those at T0,and IL-6,IL-8,TNF-α and Cor in the experimental group at various time points were lower than those in the control group(P＜0.05).At 24 h after operation,CD4+ decreased significantly and CD8+ increased significantly in the two groups compared to those preoperative,but CD4+ in the experimental group was higher than that in the control group,and CD8+ was lower than that in the control group(P＜0.05).At 6,12,24,48 h after operation,the VAS scores of the two groups decreased gradually,and those in the experimental group were lower than those in the control group(P＜0.05).Conclusion:The application of ultrasound guided SAPB combined with general anesthesia in MRM patients can alleviate stress and inflammatory reactions,alleviate pain levels,and have a certain degree of immune protection.
关键词
乳腺癌改良根治术/全麻/前锯肌平面阻滞/免疫功能Key words
Modified radical mastectomy for breast cancer/General anesthesia/Serratus anterior plane block/Immune function引用本文复制引用
基金项目
江西省卫生健康委科技项目(20202013)
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据