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目的:分析地塞米松对接受乳癌根治术的患者术后恶心呕吐、血糖、皮质醇、出血和感染的影响,明确其临床使用的有效性和安全性。方法:将160例择期全麻下行单侧乳癌改良根治术的女性患者随机分为实验组(地塞米松组,n=80)和对照组(生理盐水组,n=80)。检测两组患者术后第1天和第3天血糖和血清皮质醇水平,记录术后1~3天恶心呕吐次数和抗呕吐药物的使用量,比较两组术后1周内出血和感染的发生情况。结果:实验组患者术后第1天的恶心发生率显著低于对照组,术后1~2天的呕吐发生率均显著低于对照组,术后第1天血清皮质醇较对照组显著降低(P<0.05)。两组患者术后血糖水平比较无统计学差异(P>0.05)。术后1周内,两组患者出血和感染的发生情况比较均无显著性差异(P>0.05)。结论:地塞米松可有效地预防乳癌改良根治术患者术后恶心呕吐,短暂抑制术后内源性皮质醇水平,不增加患者术后高血糖、出血和感染的风险。
Objective: To analyze the effect of dexamethasone on postoperative nausea, vomit, blood sugar, cortisol, hemorrhage and infection in patients undergoing radical mastectomy and to determine the effectiveness and safety of the clinical application. Methods: A total of 160 female patients undergoing modified radical mastectomy with unilateral breast cancer undergoing selective general anesthesia were randomly divided into experimental group (dexamethasone group, n = 80) and control group (n = 80). Blood glucose and serum cortisol levels were measured on the first day and the third day after operation in both groups. The number of nausea and vomiting and the anti-emetic drugs were recorded 1 ~ 3 days after operation. Bleeding and infection were compared within two weeks after operation Happening. Results: The incidence of nausea on the first day after operation in the experimental group was significantly lower than that in the control group. The incidence of vomiting was significantly lower in the experimental group than in the control group after 1 ~ 2 days. The level of serum cortisol in the experimental group was significantly lower than that in the control group (P <0.05). There was no significant difference in postoperative blood glucose levels between the two groups (P> 0.05). Within one week after operation, there was no significant difference in bleeding and infection between the two groups (P> 0.05). Conclusion: Dexamethasone can effectively prevent postoperative nausea and vomiting in patients with modified radical mastectomy and shorten the postoperative endogenous cortisol levels without increasing the risk of postoperative hyperglycemia, bleeding and infection.