腹横肌平面阻滞联合地佐辛用于胃癌患者术后镇痛的效果及对热休克蛋白70水平的影响

Effects of transversus abdominis plane block combined with dezocine on postoperative analgesia and the level of heat shock protein 70 in gastric cancer patients

目的:探讨超声引导下腹横肌平面阻滞(TAPB)联合地佐辛应用于胃癌根治术患者术后镇痛的效果及对血浆热休克蛋白70(HSP70)水平的影响。方法:选取2015年4—11月在广西医科大学第一附属医院行胃癌根治术的患者60例,按术后镇痛方法不同随机分为地佐辛组、TAPB联合地佐辛组和对照组,每组20例。采用视觉模拟评分法(VAS)评估患者术后疼痛程度,酶联免疫吸附试验(ELISA)方法检测患者血浆中HSP70的含量,并观察患者术后48h内不良反应的发生情况。结果:地佐辛组和TAPB联合地佐辛组患者术后VAS评分及总不良反应发生率均明显低于对照组(均P<0.05),且TAPB联合地佐辛组VAS评分低于地佐辛组(P<0.05)。与对照组比较,地佐辛组和TAPB联合地佐辛组患者术后血浆HSP70含量明显升高(P<0.05),且TAPB联合地佐辛组HSP70含量明显高于地佐辛组(P<0.05)。结论:TAPB联合地佐辛可有效缓解胃癌根治术患者的术后疼痛,并诱导HSP70表达的增加,促进患者术后康复。

Objective： To investigate the effects of ultrasound-guided transversus abdominis plane block （TAPB） combined with dezocine on postoperative analgesia and the plasma level of heat shock protein 70 （HSP70） in patients with gastric cancer. Methods： 60 patients underwent radical operation of gastric cancer in our hospital from April 2015 to November 2015 were selected and divided into 3 groups （n=20） ： dezocine group, TAPB＋dezocine group and control group, according to different postoperative analgesic methods. The degree of postoperative pain was assessed by visual analogue scale （VAS） score. The content of HSP70 in plasma was measured by enzyme-linked immuno sorbent assay （ELISA）. The adverse reactions were recorded at 48 h after operation. Results： The postoperative VAS score and the total incidence of adverse reactions in dezocine group and TAPB＋dezocine group were lower than those in the control group （P 〈0.05）, and were more significantly lower in TAPB＋dezocine group than those in the dezocine group （P 〈0.05）. Compared with the control group, the plasma level of HSP70 in dezocine group and TAPB＋ dezocine group was markedly increased （P〈0.05）, and the HSP70 level was obviously higher in TAPB＋ dezocine group （P〈0.05）. Conclusion. TAPB combined with dezocine could effectively relieve pain and increase the level of HSP70 in plasma in gastric cancer patients after radical operation and promote postoperative rehabilitation of patients.