摘要目的:探讨超声引导下前锯肌平面阻滞（ultrasound-guided serratus plane block，US-SPB）对乳腺癌根治术患者应激反应及血清糖类抗原153（cancer antigen 153，CA153）、神经元特异性烯醇化酶（neuron-specific enolase，NSE）水平的影响。方法:选取2022年2月至2024年2月于汉中市中心医院进行收治的110例拟行乳腺癌手术的患者作为研究对象，依据随机数字表原则，将110例患者分为US-SPB组和对照组，每组各55例，分别给予US-SPB及常规麻醉，观察两组应激指标、肿瘤指标、疼痛及镇静情况、手术相关指标差异。结果:术后24 h，US-SPB组血清皮质醇（cortisol，Cor）、肾上腺素（epinephrine，EPI）和去甲肾上腺素（noradrenaline，NE）显著低于对照组（ t=4.69、5.07、5.38， P<0.05）；US-SPB组血清CA153、NSE水平显著低于对照组（ t=2.15、2.04， P<0.05）；术后6、12、24 h，US-SPB组视觉模拟评分法（visual analogue scales，VAS）评分、Ramsay镇静评分（ramsay sedation score，RSS）显著低于对照组（VAS: F组间=17.67， P组间<0.05； F时间=15.58， P时间<0.05； F交互=0.96， P交互>0.05；RSS： F组间=12.77， P组间<0.05； F时间=10.88, P时间<0.05； F交互=0.32， P交互>0.05）；US-SPB组术中瑞芬太尼使用量、术后舒芬太尼用量显著低于对照组（ t=1.99， P<0.05）。 结论:US-SPB不仅能减少乳腺癌根治术患者应激反应，同时对于肿瘤标志物水平的降低同样有积极作用，疼痛管理效果更佳。

abstractsObjective:To investigate the effects of ultrasound-guided serratus plane block (US-SPB) on stress response, serum cancer antigen 153 (CA153) and neuron-specific enolase (NSE) levels in patients undergoing radical mastectomy.Methods:A total of 110 patients with radical mastectomy who were admitted to our hospital from Feb. 2022 to Feb. 2024 were chosen and separated into US-SPB group ( n=55, US-SPB) and control group ( n=55, conventional anesthesia) by the principle of random number table. The differences of stress index, tumor index, pain, sedation, and operation related index were observed between the two groups. Results:24h after operation, serum cortisol (Cor), epinephrine (EPI) and noradrenaline (NE) in US-SPB group were significantly lower than those in control group ( t=4.69, 5.07, 5.38, P<0.05) ; The levels of serum CA153 and NSE in US-SPB group were significantly lower ( t=2.15, 2.04, P<0.05) ; The visual analogue scales (VAS) scores and Ramsay sedation score (RSS) scores in US-SPB group were significantly lower at 6h, 12h and 24h after surgery (VAS: Finter-group =17.67, Pinter-group <0.05; Ftime =15.58, Ptime <0.05; Finteraction =0.96, Pinteraction > 0.05; RSS: Finter-group =12.77, Pinter-group <0.05; Ftime =10.88, Ptime <0.05; Finteraction =0.32, Pinteraction > 0.05) ; The intraoperative dosage of remifentanil and the postoperative dosage of sufentanil in US-SPB group were significantly lower ( t=1.99, P<0.05) . Conclusion:US-SPB can not only reduce the stress response of patients undergoing radical mastectomy, but also have a positive effect on the reduction of tumor marker levels, and the pain management effect is better.