摘要
探讨超声影像技术结合地佐辛、右美托咪定在乳腺癌根治术中的应用价值。选取126例乳腺癌根治术患者为研究对象,采用随机数字表法分为两组,地佐辛组合联合组各63例。两组均采取超声影像定位下竖脊肌阻滞,地佐辛组静脉滴注5 mg地佐辛,联合组地佐辛用法用量同地佐辛组,先静脉滴注0.5μg/kg右美托咪定,继以0.3μg/(kg·h)持续泵注右美托咪定。应用心电监护仪检测血流动力学指标,采用视觉模拟评分(VAS)、Ramsay镇静评分评价镇痛、镇静程度,采用酶联免疫吸附法测定炎症应激指标,同时比较恢复质量及不良反应。结果显示,联合组T1、T2、T3、T4时平均动脉压(MAP)、心率(HR)低于地佐辛组,且波动幅度小于地佐辛组(P<0.05);联合组术后3 h、6 h、12 h、24 h、48 h的VAS、Ramsay镇静评分低于地佐辛组(P<0.05);联合组术后3 d血清肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)表达低于地佐辛组,NK细胞表达高于地佐辛组(P<0.05);联合组术后48 h,自控静脉镇痛泵(PCIA)试图按压次数、有效按压次数少于地佐辛组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。超声影像技术结合地佐辛、右美托咪定应用于乳腺癌根治术患者取得满意镇静镇痛效果,可稳定血流动力学,提高术后早期恢复质量,且对炎症应激影响较小,安全性高。
This paper investigated the value of ultrasound imaging techniques combined with dezocine and dexmedetomidine in radical mastectomy of breast cancer. 126 patients with radical breast cancer were selected as research subjects, and they were divided into two groups with 63 cases in each group using random number table method. Both the two groups were treated with erector spinae block by ultrasound imaging, 5 mg of dezocine was administered intravenously in the dezocine group, and in the combined group the dosage of dezocine was the same as that in the dezocine group, and then 0.5 μg/kg of dexmedetomidine was administered intravenously, followed by 0.3 μg/(kg·h) of dexmedetomidine pumped continuously. Cardiac monitors were applied to detect hemodynamic indexes, visual analog scoring(VAS) and Ramsay sedation scoring were used to evaluate the degree of analgesia and sedation,and enzyme-linked immunosorbent assay was used to determine the inflammatory stress indexes,while the quality of recovery and adverse effects were compared.The results showed the mean arterial pressure(MAP)and heart rate(HR) at T1,T2,T3 and T4 in the combined group were lower than those in the dezocine group,and the fluctuations were less than those in the dezocine group(P<0.05).The VAS and Ramsay scores at 3h,6h,12h,24h and 48h after surgery in the combined group were lower than those in the dezocine group(P<0.05).The serum tumor necrosis factor-alpha(TNA-α),interleukin-10(IL-10) in the combined group was lower than those in the dezocine group at 3d after surgery,while the expression of NK cells was higher than that in the dezocine group(P <0.05).The number of attempted compressions and effective compressions by the automatic intravenous analgesia pump(PCIA)in the combined group was less than that in the dezocine group at 48h after surgery(P<0.05).The comparison of the incidence of adverse reactions between the two groups,there was no statistically significant(P>0.05).Ultrasound imaging technology combined with dezocine and dexmedetomidine wa
作者
缪凡
苑璐宁
高小丽
李柏珍
王可心
MIU Fan;YUAN Luning;GAO Xiaoli;LI Baizhen;WANG Kexin(Chengde Central Hospital,Chengde 067000,Hebei,China)
出处
《影像科学与光化学》
CAS
北大核心
2022年第5期1215-1220,共6页
Imaging Science and Photochemistry
基金
承德市科学技术支撑课题计划(202006A045)。
关键词
乳腺癌根治术
超声定位
地佐辛
右美托咪定
竖脊肌阻滞
恢复质量
镇痛效果
radical mastectomy for breast cancer
ultrasound positioning
dezocine
dexmedetomidine
erector spinae block
restoration quality
analgesic effect
