右美托咪定先发制人镇痛在乳腺肿瘤切除术中的临床疗效。

IF 1.7 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
American journal of translational research Pub Date : 2024-12-15 eCollection Date: 2024-01-01 DOI:10.62347/HLKF8121
Zhao Zhang, Jing Zhang, Peng Zhang, Zhenguo Song
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引用次数: 0

摘要

目的:探讨右美托咪定先发制人镇痛在乳房切除术患者中的临床疗效。方法:对236例乳腺肿瘤切除术患者进行回顾性研究。其中,对照组131例患者术后常规静脉自控镇痛,先发制人镇痛组105例患者术中使用右美托咪定先发制人镇痛。统计分析视觉模拟量表(VAS)评分、Ramsay镇静评分、临床疗效、疼痛介质水平、肾功能指标、免疫功能指标及不良反应。结果:先发制人镇痛组术后VAS评分和Ramsay评分均低于对照组(P < 0.05)。先发制人镇痛组镇痛成功率明显高于对照组(84.8% vs. 74.0%, P < 0.05)。术后疼痛介质前列腺素E2 (PGE2)、P物质(SP)、神经肽Y (NPY)水平先升高后降低,且先发制人镇痛组疼痛介质水平较术前低(P < 0.05)。肾功能指标肌酐(Cr)、血尿素氮(BUN)、中性粒细胞明胶酶相关脂钙蛋白(NGAL)变化趋势相似,均以先发制人镇痛组较低(P < 0.05)。免疫功能指标CD3+、CD4+、CD8+、CD4/CD8+比值在先发制人镇痛组的变化均小于对照组(P < 0.05)。先发制人镇痛组总不良反应发生率低于对照组(P < 0.05)。结论:右美托咪定先发制人镇痛对乳腺肿瘤切除术患者的临床疗效显著,镇痛效果更好,疼痛介质和肾功能指数水平降低,免疫功能保存改善,不良反应减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical efficacy of dexmedetomidine preemptive analgesia in breast tumor resection.

Objective: To investigate the clinical efficacy of dexmedetomidine preemptive analgesia in patients undergoing mastectomy.

Methods: A retrospective study was conducted, including 236 patients who underwent breast tumor resection. Of these, 131 patients in the control group received routine postoperative intravenous patient-controlled analgesia, while 105 patients in the preemptive analgesia group received dexmedetomidine preemptive analgesia during surgery. Visual analog scale (VAS) scores, Ramsay sedation scores, clinical efficacy, pain mediator levels, renal function indices, immune function indices, and adverse effects were statistically analyzed.

Results: The preemptive analgesia group had lower VAS scores and Ramsay scores postoperatively (both P < 0.05). The success rate of analgesia was significantly higher in the preemptive analgesia group compared to the control group (84.8% vs. 74.0%, P < 0.05). After surgery, the levels of pain mediators, including prostaglandin E2 (PGE2), substance P (SP), and neuropeptide Y (NPY), initially increased and then decreased, with lower levels observed in the preemptive analgesia group (all P < 0.05). Renal function indices, including creatinine (Cr), blood urea nitrogen (BUN), and neutrophil gelatinase-associated lipocalin (NGAL), showed a similar trend, with lower levels in the preemptive analgesia group (all P < 0.05). Immune function markers, such as CD3+, CD4+, CD8+, and CD4/CD8+ ratios, demonstrated smaller changes in the preemptive analgesia group compared to the control group (all P < 0.05). The total adverse reaction rate was lower in the preemptive analgesia group (P < 0.05).

Conclusion: Dexmedetomidine preemptive analgesia demonstrates significant clinical benefits in patients undergoing breast tumor resection, including better analgesic efficacy, reduced pain mediator and renal function index levels, improved immune function preservation, and fewer adverse reactions.

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American journal of translational research
American journal of translational research ONCOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
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