摘要
目的探析三阴性乳腺癌(TNBC)应用依托咪酯结合快速康复外科(ERAS)理念对其术后苏醒时间、认知功能的影响。方法回顾性分析选择南阳医学高等专科学校第一附属医院2020年6月至2021年7月就诊的70例TNBC患者,根据麻醉用药方案不同将患者分为两组各35例。观察组年龄(35.67±4.21)岁,肿瘤长径(1.87±0.24)cm;对照组年龄(35.59±4.27)岁,肿瘤长径(1.89±0.23)cm。两组均进行标准TNBC手术治疗,基于ERAS理念加强围手术期管理,对照组联合丙泊酚麻醉,观察组在对照组基础上联合依托咪酯麻醉。对比两组术后苏醒时间,术后2 h认知功能[简易智力状态检查(MMSE)],手术当日、手术后1 d的炎性指标[中性粒细胞与淋巴细胞比值(NLR)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)],不良反应发生率。结果两组TNBC患者不良反应发生率[5.71%(2/35)比8.57%(3/35)]、苏醒时间[(15.27±1.75)min比(15.11±1.78)min]比较差异均无统计学意义(均P>0.05);观察组MMSE评分明显高于对照组[(23.59±2.14)分比(21.27±2.03)分],术后IL-6(4.63±1.22)pg/ml、NLR(4.47±0.34)、TNF-α(7.75±2.03)pg/ml均明显低于对照组[(6.12±1.25)pg/ml、(5.69±0.38)、(9.34±2.17)pg/ml],差异均有统计学意义(均P<0.05)。结论依托咪酯结合ERAS应用于TNBC中临床效果显著。术后苏醒时间较短,安全性较高,可以有效降低麻醉对认知功能的影响,改善患者炎症因子,值得临床推广。
Objective To explore the effect of etomidate combined with the concept of enhanced recovery after surgery(ERAS)on postoperative recovery time and cognitive function in patients with triple-negative breast cancer(TNBC).Methods A retrospective analysis was performed on 70 TNBC patients in The First Affiliated Hospital of Nanyang Medical College from June 2020 to July 2021,and all of the patients were divided into two groups with 35 patients in each group according to different anesthesia medication regimens.The age of the observation group was(35.67±4.21)years old,and the tumor length was(1.87±0.24)cm;the age of the control group was(35.59±4.27)years old,and the tumor length was(1.89±0.23)cm.Both groups were treated with standard TNBC surgery,and were given strengthened perioperative management based on the concept of ERAS.The control group was combined with propofol anesthesia,and the observation group was combined with etomidate anesthesia on the basis of the control group.The postoperative recovery time,cognitive function[Mini-Mental State Examination(MMSE)]2 h after the surgery,inflammatory indicators[neutrophil to lymphocyte ratio(NLR),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]on the day of surgery and 1 d after the surgery,and incidence of adverse reactions were compared between the two groups.Results There were no statistically significant differences in the incidence of adverse reactions[5.71%(2/35)vs.8.57%(3/35)]and recovery time[(15.27±1.75)min vs.(15.11±1.78)min]between the two groups(both P>0.05).The MMSE score of the observation group was significantly higher than that of the control group[(23.59±2.14)points vs.(21.27±2.03)points],the postoperative IL-6[(4.63±1.22)pg/ml],NLR[(4.47±0.34)],TNF-α[(7.75±2.03)pg/ml]levelswere significantly lower than those of the control group[(6.12±1.25)pg/ml,(5.69±0.38),and(9.34±2.17)pg/ml],with statistically significant differences(all P<0.05).Conclusion Etomidate combined with ERAS has a higher application value in TNBC,with short postoperative recovery time and high safety,which can effectively reduce the impact of anesthesia on cognitive function and improve patients'inflammatory factors,worthy of clinical promotion.
作者
贾梦钦
李喜龙
Jia Mengqin;Li Xilong(Operating Room,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China;Department of Anesthesiology,Henan Cancer Hospital,Zhengzhou 450000,China)
出处
《国际医药卫生导报》
2021年第24期3769-3772,共4页
International Medicine and Health Guidance News
基金
河南省医学科技攻关项目(LHGJ20200184)。
关键词
依托咪酯
快速康复外科理念
三阴性乳腺癌
术后苏醒时间
认知功能
Etomidate
Concept of enhanced recovery after surgery
Triple-negative breast cancer
Postoperative recovery time
Cognitive function
