临床外科杂志 ›› 2026, Vol. 34 ›› Issue (6): 645-648.doi: 10.3969/j.issn.1005-6483.20250090

• 论著 • 上一篇    下一篇

超声引导下胸神经阻滞与胸椎旁神经阻滞对乳腺癌根治术后麻醉效果的比较

郭延洪,唐璟,卢世霞,包煜忠,赵雪梅,阿良德,刘震   

  1. 青海大学附属医院麻醉科
  • 收稿日期:2025-01-24 出版日期:2026-08-18 发布日期:2026-08-18
  • 通讯作者: 阿良德
  • 作者简介:郭延洪,唐璟,卢世霞,包煜忠,赵雪梅,阿良德,刘震
  • 基金资助:
    青海大学附属医院中青年科研基金一般项目(ASRF-2024-YB-07)

Comparison of postoperativeanalgesic effect of ultrasound-guided PECS block and ultrasound guided paravertebral block in radical surgery for breast cancer

GUO Yanhong,TANG Jing,LU Shixia,BAO Yuzhong,ZHAO Xueme,A Liangde,LIU Zhen   

  1. Department of Anesthesiology,Affiliated Hospital of Qinghai University
  • Received:2025-01-24 Online:2026-06-20 Published:2026-08-18

摘要: 目的 探讨超声引导下胸神经阻滞(PECS)与胸椎旁神经阻滞(TPVB)对乳腺癌根治术后的麻醉效果。方法 2021年4月~2024年4月本院收治的乳腺癌病人102例,均接受乳腺癌根治术治疗。按随机数字表法分为A组和B组,每组各51例。A组采用PECS,B组采用TPVB。比较两组围术期指标、术后疼痛情况、应激反应指标、炎症反应指标、认知功能及不良反应。结果 两组术中输液量、失血量、手术时间和住院时间比较差异无统计学意义(P>0.05);A组术后不同时间点视觉模拟评分(VAS)低于B组,差异有统计学意义(P<0.05);术后A组肿瘤坏死因子(TNF)-α、肾上腺素(E)、白细胞介素(IL)-6、去甲肾上腺素(NE)水平显著低于B组,两组比较差异有统计学意义(P<0.05);A组简易精神状态检查量表(MMSE)评分高于B组,差异有统计学意义(P<0.05)。两组低血压、呕吐等发生率比较差异无统计学意义(P>0.05)。结论 行乳腺癌根治术病人采用PECS,术后疼痛反应较轻,应激损伤较小,镇痛效果理想。

关键词: 乳腺癌; 超声引导; 胸神经阻滞; 胸椎旁神经阻滞; 镇痛效果

Abstract: Objective To investigate the anesthetic effect of ultrasound-guided pectoral nerve block (PECS) and thoracic paravertebral block (TPVB) in breast cancer patients undergoing radical surgery. Methods A total of 102 breast cancer patients admitted to our hospital from April 2021 to April 2024 were selected and all received radical mastectomy for breast cancer.They were randomly divided into Group A and Group B by the random number table method,with 51 cases in each group.Group A used PECS,and Group B used TPVB.The perioperative indicators,postoperative pain,stress response indicators,inflammatory response indicators,cognitive function,and untoward reactions of both groups were compared. Results There was no statistically significant difference in intraoperative infusion,blood loss volume,operation and hospital stay between group A and group B (P>0.05).The visual analogue scale (VAS) scores of group A at different time points after surgery were prominently lower than those of group B (P<0.05).After surgery,tumor necrosis factor-α (TNF-α),adrenaline (E),interleukin-6 (IL-6),and norepinephrine (NE) in group A were prominently lower than those in group B (P<0.05).The Mini Mental State Examination (MMSE) score in group A was prominently higher than that in group B (P<0.05).Moreover,there was no statistically significant difference in the incidence of hypotension,vomiting,etc(P>0.05).Conclusion Ultrasound guided PECS for breast cancer patients undergoing radical mastectomy has less postoperative pain response,less stress injury,and ideal analgesic effect.

Key words: breast cancer; ultrasound guidance; pectoral nerve block; thoracic paravertebral block; analgesic effect

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