地塞米松联合帕洛诺司琼预防...腔镜食管癌根治术患者的影响_游嘉.pdf

-120-Chinese and Foreign Medical Research Vol.21,No.11 April,2023经验体会 Jingyantihui中外医学研究第 21 卷 第 11 期（总第 559 期）2023 年 4月后应激障碍的影响 J.浙江医学，2020，（2）：171-174.18 丛海涛，丁进峰，何海娟，等.右美托咪定对创伤后应激障碍大鼠核因子-B 抑制蛋白激酶/核因子-B 抑制蛋白/核因子 B 通路及认知功能障碍的影响 J.解剖学报，2022，53（3）：295-301.19 KOVACIC PETROVIC Z，NEDIC ERJAVEC G，NIKOLAC PERKOVIC M，et al.The Association between serotonin transporter polymorphism,platelet serotonin concentration and insomnia in non-depressed veterans with posttraumatic stress disorderJ.Psychiatr Danub，2019，31（1）：78-87.20 朱晓梦，李铭明，李建萌.创伤后应激障碍小鼠海马组织炎性因子水平与行为学的关系 J.中华实验外科杂志，2021，38（6）：1096-1098.21 刘婷婷，费英俊，李月.剖宫产后创伤后应激障碍调查及其影响因素分析 J.中国医师杂志，2020，22（5）：714-717，722.（收稿日期：2023-02-27）（本文编辑：马娇）福建省肿瘤医院福建福州350014通信作者：陈巧玲地塞米松联合帕洛诺司琼预防性用药对胸腔镜食管癌根治术患者的影响 游嘉陈巧玲【摘要】目的：分析地塞米松联合帕洛诺司琼预防性用药对胸腔镜食管癌根治术患者的影响。方法：选取 2020 年 3 月2022 年 3 月福建省肿瘤医院收治的 86 例食管癌患者。随机将其分为地塞米松组（n=29）、帕洛诺司琼组（n=28）、联合组（n=29）。所有患者均实施常规麻醉及胸腔镜食管癌根治术治疗。地塞米松组麻醉前静脉注射地塞米松磷酸钠注射液，帕洛诺司琼组麻醉前静脉注射盐酸帕洛诺司琼注射液，联合组麻醉前静脉注射盐酸帕洛诺司琼注射液 0.25 mg+地塞米松磷酸钠注射液 10 mg。比较三组术后 24 h 内胃肠道反应发生率，术前及术后 24 h 胃肠激素水平、炎症因子水平。结果：术后 24 h，联合组胃肠道反应发生率显著低于地塞米松组、帕洛诺司琼组，差异有统计学意义（P0.05）。术后 24 h，三组胃泌素（GSA）、胃动素（MTL）水平均显著低于术前，联合组 GSA、MTL 水平均显著高于地塞米松组、帕洛诺司琼组，差异有统计学意义（P0.05）。术后 24 h，三组干扰素-（IFN-）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）水平均显著高于术前，联合组 IFN-、IL-6、IL-10 水平均显著低于地塞米松组、帕洛诺司琼组，差异有统计学意义（P0.05）。结论：地塞米松、帕洛诺司琼单独预防性用药对胸腔镜食管癌根治术患者胃肠道不良反应、胃肠激素及炎症因子影响效果相近，联合用药能降低胃肠道不良反应发生率，对胃肠激素及炎症因子影响优于二者单独用药。【关键词】地塞米松帕洛诺司琼胸腔镜食管癌根治术胃肠道反应胃肠激素doi：10.14033/ki.cfmr.2023.11.031 文献标识码B 文章编号1674-6805（2023）11-0120-04Effect of Prophylactic Medication with Dexamethasone Combined with Palonosetron on Patients Undergoing Thoracoscopic Radical Resection of Esophageal Cancer/YOU Jia,CHEN Qiaoling./Chinese and Foreign Medical Research,2023,21(11):120-123AbstractObjective:To analyze the effect of prophylactic medication with Dexamethasone combined with Palonosetron on patients undergoing thoracoscopic radical resection of esophageal cancer.Method:A total of 86 patients with esophageal cancer admitted to Fujian Cancer Hospital from March 2020 to March 2022 were selected.They were randomly divided into Dexamethasone group(n=29),Palonosetron group(n=28)and combined group(n=29).All patients were treated with conventional anesthesia and thoracoscopic radical resection of esophageal cancer.The Dexamethasone group was given intravenous Dexamethasone Sodium Phosphate Injection before anesthesia,the Palonosetron group was given intravenous Palonosetron Hydrochloride Injection before anesthesia,and the combined group was given intravenous Palonosetron Hydrochloride Injection 0.25 mg+Dexamethasone Sodium Phosphate Injection 10 mg before anesthesia.The incidence of gastrointestinal reactions within 24 h after operation,the levels of gastrointestinal hormones and inflammatory factors before and 24 h after operation were compared among the three groups.Result:At 24 h after operation,the incidence of gastrointestinal reactions in the combined group was significantly lower than that in the Dexamethasone group and the Palonosetron group,and the differences were statistically significant(P0.05），有可比性。本次研究经本院医学伦理委员会审核批准，患者及其家属签署知情同意书。1.2方法所有患者均实施常规麻醉及胸腔镜食管癌根治术治疗。地塞米松组麻醉前静脉注射地塞米松磷酸钠注射液（辰欣药业股份有限公司，国药准字H37021969）10 mg；帕洛诺司琼组麻醉前静脉注射盐酸帕洛诺司琼注射液（江苏恒瑞医药股份有限公司，国药准字 H20140043）0.25 mg；联合组麻醉前静脉注射盐酸帕洛诺司琼注射液 0.25 mg+地塞米松磷酸钠注射液 10 mg。1.3观察指标及评价标准（1）胃肠道反应：比较三组术后 24 h 内胃肠道反应发生率（恶心、呕吐、食欲不振）。（2）胃肠激素水平：分别于术前及术后 24 h 采集三组空腹静脉血离心后分离血清，使用酶联免疫吸附法检测胃泌素（GSA）水平，以化学发光法检测胃动素（MTL）水平。（3）炎症因子水平：术前及术后 24 h 采集三组患者空腹静脉血离心后分离血清，使用酶联免疫分析法检测其中白细胞介素-6（IL-6）、白 细 胞 介 素-10（IL-10）、干 扰 素-（IFN-）水平。1.4统计学处理本研究数据采用 SPSS 22.0 统计学软件进行分析和处理，计量资料以（x-s）表示，两组比较采用 t 检验，多组比较采用单因素方差分析，计数资were significantly lower than those before operation,and the levels of GSA and MTL in the combined group were significantly higher than those in the Dexamethasone group and the Palonosetron group,the differences were statistically significant(P0.05).At 24 h after operation,the levels of interferon-(IFN-),interleukin-6(IL-6)and interleukin-10(IL-10)in the three groups were significantly higher than those before operation,the levels of IFN-,IL-6 and IL-10 in the combined group were significantly lower than those in Dexamethasone group and Palonosetron group,the differences were statistically significant(P0.05).Conclusion:Prophylactic medication with Dexamethasone or Palonosetron alone have similar effects on gastrointestinal adverse reactions,gastrointestinal hormones and inflammatory factors in patients with thoracoscopic radical resection of esophageal cancer,but the combined medication can reduce the incidence of gastrointestinal adverse reactions and have better effects on gastrointestinal hormones and inflammatory and immune factors than the two alone.Key wordsDexamethasonePalonosetronThoracoscopic radical resection of esophageal cancerGastrointestinal reactionsGastrointestinal hormonesFirst-authors address:Fujian Cancer Hospital,Fuzhou 350014,China-122-Chinese and Foreign Medical Research Vol.21,No.11 April,2023经验体会 Jingyantihui中外医学研究第 21 卷 第 11 期（总第