[关键词]
[摘要]
目的: 应激状态下血浆内皮素－1( Endothelin; ET) 是损伤胃黏膜的重要致病因子。痛会引起强烈的
应激反应，通过检测胃癌术后病人外周血中ET－1 水平，从而探讨有效术后镇痛对胃癌病人术后血浆ET－1 有何
影响。方法: 50 例ASAI 级或II 级择期行胃癌根治术病人，随机均分为两组: 镇痛组与对照组( 未行镇痛组) ，各
25 例，记录术后6 h、12 h、24 h 静息疼痛视觉模拟评分( VAS) 和Ram－Say 镇静评分及术后肛门排气时间、拔胃管
时间、进食流质时间。分别于术前、术后6、12 h 采外周血应用放射免疫法检测血浆ET－1 的水平。结果: 镇痛组
与对照组两组病人术前ET－1 水平无显著差异，而在术后6 h 与术后12 h 的时间点上两组血浆ET－1 水平均有
有明显差异( P＜0． 05) ，镇痛组术后ET－1 水平明显低于对照组。各组内不同时间点指标比较: 对照组ET－1 水
平在各时间点均有明显差异( P＜0． 05) ，术后6 h ET－1 水平最高，术后12 h ET－1 水平次之，但都高于术前; 镇痛
组在不同时间点的ET－1 水平均无明显差异。结论: 有效的术后镇痛可抑制血浆ET－1 水平升高，从而降低由
ET－1 对胃黏膜的损伤，术后镇痛对胃癌根治术病人术后恢复是有益的。
[Key word]
[Abstract]
Objective: Under stress ( Endothelin; ET) is an important pathogenic factor of gastric
mucosal injury． Pain may cause a strong stress response，by detecting the peripheral blood of gastric
carcinoma patients plasma endothelin－1( ET－1) levels． To explore effective postoperative analgesia on
postoperative gastric carcinoma patients plasma ET－1 impact． Methods: 50 cases of ASAI or II grade
elective resection of gastric carcinoma patients were randomly divided into two groups: Analgesia group
and the control group( no analgesia group) of the 25 cases． Record after 6 h， 12 h，24 h resting pain visual
analogue scale ( VAS) and Ram－ Say sedation and postoperative anal exhaust time，pulling tube
time，eating liquid time，Respectively，before operation 6 h、after 12 h blood detecting sample of plasma
ET－1 levels by radioimmunoassay． Results: Two groups of patients before operation no difference at ET
－1 levels， In the postoperative time of 6 h and 12 h ET－1 levels are significantly different( P＜0． 05) ，
ET－1 analgesia group were significantly lower than the control group． Through the different time points
within the each group Comparative， the control group of ET－1 levels at each time point were significantly
different( P＜0． 05) ，Postoperative 6 h ET－1 levels the highest，Postoperative 12 h ET－1 was
second，but higher than preoperative，Analgesia group at different time points of ET－1 levels were not
significantly different． Conclusion: Effective postoperative analgesia can inhibit plasma levels of ET－1，
Reducing gastric mucosal injury． This research found that patients of gastric carcinoma postoperative
radical operation recovery of gastrointestinal function are useful．
[中图分类号]
R735． 3
[基金项目]
收稿日期: 2013－09－15; 修回日期: 2013－11－14
基金项目: 内蒙古自然科学基金项目( 2012MS1180)
作者简介: 查木哈格( 1981－) ，女，蒙古族，内蒙古医科大学附属医院主治医师。
通讯作者: 侯明星，主任医师，硕士研究生导师． E－mail:
XXL812458@163． com． 内蒙古医科大学附属医院， 010050
