| 徐博,崔晓,宋辐,李璠,张苑珑.肋间神经前皮支联合肋间臂支阻滞对乳腺癌术后镇痛效果分析.[J].中南医学科学杂志.,2022,(2):253-256. |
| 肋间神经前皮支联合肋间臂支阻滞对乳腺癌术后镇痛效果分析 |
| Analysis of the effect of combined block of anterior skin branch of intercostal nerve and brachial intercostal branch on postoperative analgesia of breast cancer |
| 投稿时间：2021-05-21 修订日期：2021-12-08 |
| DOI：10.15972/j.cnki.43-1509/r.2022.02.024 |
| 中文关键词: 肋间神经前皮支阻滞 肋间臂支阻滞 乳腺癌 镇痛 |
| 英文关键词:anterior skin branch of intercostal nerve block intercostal brachial branch block breast cancer analgesia |
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| 中文摘要: |
| 目的探讨肋间神经前皮支阻滞在乳腺癌术后早期镇痛中的应用价值。方法选取乳腺癌根治术患者98例,随机均分为联合组和对照组,对照组术后采用肋间臂支阻滞镇痛,联合组在对照组基础上联合肋间神经前皮支阻滞镇痛。比较两组患者术后24 h累积吗啡用量、视觉模拟疼痛程度评分(VAS)、T淋巴水平、皮质醇、血管紧张素Ⅱ、去甲肾上腺素、肾上腺素水平。结果联合组术后24 h累积吗啡用量低于对照组(P＜0.05)。联合组静息状态下术后4 h和24 h、咳嗽状态下术后4 h和12 h VAS评分低于对照组(P＜0.05)。术后24 h联合组CD3＋、CD4＋/CD8＋水平高于对照组,皮质醇、血管紧张素Ⅱ、去甲肾上腺素、肾上腺素水平低于对照组(P＜0.05)。结论肋间神经前皮支阻滞联合肋间臂支阻滞在乳腺癌术后早期镇痛中镇痛效果良好,对免疫系统及应激反应有一定的影响。 |
| 英文摘要: |
| To explore the application value of intercostal nerve anterior skin branch block in early analgesia after breast cancer surgery. Methods98 patients with radical mastectomy were randomly divided into two groups:the combined group and the control group. The control group received intercostal brachial block analgesia after operation, and the combined group was treated with anterior intercostal nerve block analgesia on the basis of the control group. The cumulative dosage of morphine, visual analogue pain scale (VAS), t-lymph level, cortisol, angiotensin Ⅱ, norepinephrine and epinephrine were compared between the two groups 24 hours after operation. ResultsThe cumulative morphine dosage at 24 hours in the combined group was lower than that in the control group (P＜0.05). VAS scores in the combined group were lower than those in the control group at 4 h and 24 h after operation in the resting state and 4 h and 12 h after operation in the cough state (P＜0.05). The levels of CD3＋, CD4＋/CD8＋ in the combined group were higher than those in the control group 24 hours after operation, and the levels of cortisol, angiotensin Ⅱ, norepinephrine and epinephrine in the combined group were lower than those in the control group (P＜0.05). ConclusionIntercostal nerve anterior cutaneous branch block and intercostal brachial block has good analgesic effect in early postoperative analgesia for breast cancer patients. Reducing surgical trauma has a certain impact on patients' immune system and stress response. |
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