超声引导下前锯肌平面阻滞对乳腺癌改良根治术术后肿瘤转移、复发的影响

Influence of ultrasound-guided serratus plane block on metastasis and recurrence of breast cancer after modified radical mastectomy

目的探讨超声引导下前锯肌平面(SP)阻滞对乳腺癌改良根治术术后免疫因子及基质金属蛋白酶(MMPs)的影响。方法选择2015年6月-2017年6月于本院择期行乳腺癌改良根治术的患者60例,随机平均分为两组:SP阻滞组(S组)和对照组(C组)。两组在麻醉诱导后均接受超声引导下SP穿刺,S组注射0.5%罗哌卡因15 mL,C组注射等容量生理盐水。观测两组患者术前30 min(T0)、术后3 h(T1)、术后24 h(T2)的血清IL-10和MMP-2、MMP-9的变化情况。结果两组患者IL-10浓度在T0、T1、T2呈明显升高趋势(P<0.05)。S组IL-10浓度在T1、T2均显著高于C组(P<0.05)。两组患者MMP-2、MMP-9浓度在T0、T1、T2均呈明显升高趋势(P<0.05)。S组MMP-2、MMP-9浓度在T1、T2均显著低于C组(P<0.05)。结论超声引导下SP阻滞可有效减少全麻下行乳腺癌改良根治术术后肿瘤转移、复发的可能性。

Objective To study the Influence of ultrasound-guided serratus plane(SP)block on metastasis and recurrence of breast cancer after modified radical mastectomy.Methods Sixty patients received selected modified radical mastectomy between June,2015 and June,2017 were enrolled in this study.The patients were randomly divided into two groups:SP block group(group S)and control group(group C),30 patients respectively.Two groups received ultrasound-guided SP block after anaesthesia induction,group S received 0.5%ropivacaine injection and group C received saline.The concentration of indicators were tested 30 minutes before surgery(T0),3 hours after surgery(T1)and 24 hours after surgery(T2).Results The trend of IL-10,MMP-2,MMP-9 were significantly increased at T0,T1,T2(P<0.05).The concentration of IL-10 in group S were significantly higher than in group C at T1,T2(P<0.05).Conclusion Ultrasound-guided SP block can effectively decrease the metastasis and recurrence rate of breast cancer after modified radical mastectomy.