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1、氯诺昔康超前镇痛对乳腺癌改良根治术后疼痛及血小板CD62p的影响作者：王春玲 张丽 李建军 马榕作者单位：山东大学齐鲁医院 1麻醉科 2普外科 【摘要】目的：通过观察氯诺昔康超前镇痛对乳腺癌改良根治术后疼痛的影响以及氯诺昔康对血小板CD62p表达的影响，判定氯诺昔康超前镇痛的有效性和围手术期应用的安全性。方法：将择期行乳腺癌改良根治术的60例患者随机分为超前镇痛组(Ⅰ组,n=30)和对照组(Ⅱ组,n=30)，均在气管插管全身麻醉下手术。Ⅰ组患者术前30min给予氯诺昔康16mg，Ⅱ组患者给予生理盐水4mL。两组患者均在
2、术前30min和术后6h和24h3个时相点抽取静脉血2mL，测定血小板CD62p的表达；观察术后2、6和24h时静息疼痛视觉模拟（visualanaloguescale，VAS）评分，记录术中出血量及术后24、48和72h引流液的量，记录两组患者术后3d恶心、呕吐的发生及术后镇痛药物应用情况。结果：两组患者VAS评分在术后2、6和24h3个时相点均有差异，Ⅰ组患者疼痛明显减轻（P<0.05）；每组患者3个时点血小板CD62p的表达有差异，术后CD62p的表达明显高于术前（P<0.05）；两组间术后24h镇痛药物的需求有
3、差异；两组间术中出血量、术后引流液的量无差异；两组患者恶心、呕吐发生率无差异，未发现其他相关不良反应。结论：氯诺昔康超前镇痛能明显减轻患者术后疼痛，氯诺昔康单剂16mg应用并未明显影响血小板活化聚集功能，可安全应用于围手术期。【关键词】氯诺昔康·超前镇痛·疼痛视觉模拟评分·血小板活化Effectofpre-emptiveanalgesiawithlornoxicamonpainandtheexpressionofpselectinonplateletaftermodifiedradicalmastectomyWANGC
4、hun-ling1,ZHANGLi1,LIJian-jun1,MARong21DepartmentofAnesthesiology,2DepartmentofGeneralSurgery，QiluHospitalofShandongUniversity（Jinan250012,China）【ABSTRACT】Objective:Todeterminewhetherlornoxicamhasapreemptiveanalgesiceffecttothepatientswhoundergomodifiedradicalma
5、stectomy.Tostudytheeffectoflonoxicamonplateletfunctionandinvestigatethesurfaceexpressionofp-selectinonplateletbyaflow-cytometricassay.Methods:Afterobtainingawritteninformedconsentfrompatients,sixtyASAⅠ－Ⅱpatients，aged40-60yr,weighted40-60Kg,whowerescheduledformod
6、ifiedradicalmastectomywereincludedinthestudy.Allpatientswererandomlydividedintotwogroups.Patientsunderwentbreastsurgeryundergeneralanesthesia,GroupIwasadministered16mgoflornoxicamiv.30minutespriortosurgery,GroupIIwasadministered4mLplacebo.TwomLbloodwasdrawnfroma
7、peripheralveintoanalyzethesurfaceexpressionofp-selectinonplatelet,bloodsamplewascollectedatthreetimepoints:30minutespriortosurgery,6hand24haftersurgery.Introoperativebloodlossandthevolumeofdrainagefluid24h,48h,and72haftersurgerywasdocumented;PONVandothersideeffe
8、ctswasrecorded.Therescueanalgesicswasrecorded.Result:GroupIdemonstratedreducedpainscorescomparedtoGroupIIatthreespecifictimepoints;Greatdifferencefortheexpressionofp-
