不同麻醉方法对胃癌患者术后肺部感染的影响

发布时间：2018-03-09 22:44

本文选题：麻醉　切入点：肺部感染　出处：《中华医院感染学杂志》2015年06期 　论文类型：期刊论文

【摘要】：目的调查分析胃癌患者在不同麻醉方式下行外科手术治疗后肺部感染发生情况,为预防患者术后肺部感染提供依据。方法选择2011年3月-2014年6月医院行胃癌手术治疗的310例患者为研究对象,分为A组和B组各155例,分析不同麻醉方式肺部感染发生率、感染病原菌分布及耐药性。结果 A组患者自主呼吸恢复时间(8.6±3.5)min,明显短于B组的(12.8±5.4)min,差异有统计学意义(t=8.126,P0.01);A组患者拔管时间(12.6±3.1)min,明显短于B组的(18.2±6.6)min,差异有统计学意义(t=9.561,P0.01);A组患者术后肺部感染率1.3%,明显低于B组的5.2%,差异有统计学意义(χ2=3.934,P0.05);肺部感染病原菌分别为铜绿假单胞菌7株、鲍氏不动杆菌3株、金黄色葡萄球菌3株、阴沟肠杆菌2株和嗜麦芽寡养单胞菌1株。结论胃癌患者采用全身麻醉联合硬膜外阻滞手术,术后结合硬膜外自控镇痛,可有效缩短自主呼吸恢复时间和拔管时间,减少术后肺部感染率。
[Abstract]:Objective to investigate and analyze the incidence of pulmonary infection in patients with gastric cancer after surgical treatment under different anesthetic methods. Methods from March 2011 to June 2014, 310 patients with gastric cancer were divided into two groups: group A (n = 155) and group B (n = 155). Results the recovery time of spontaneous respiration in group A was 8.6 卤3.5 minutes, which was significantly shorter than that in group B (12.8 卤5.4 min). There was a significant difference in extubation time (12.6 卤3.1 min) between group A and group A, which was significantly shorter than that in group B (18.2 卤6.6 min). The postoperative pulmonary infection rate of group B was significantly lower than that of group B (蠂 2 3.934 P 0.05), and the pathogenic bacteria of pulmonary infection were Pseudomonas aeruginosa (7 strains). There were 3 strains of Acinetobacter baumannii, 3 strains of Staphylococcus aureus, 2 strains of Enterobacter cloacae and 1 strain of maltophoid oligotrophomonas. Conclusion patients with gastric cancer were treated with general anesthesia combined with epidural block and postoperative patient-controlled epidural analgesia. It can effectively shorten the time of spontaneous respiratory recovery and extubation, and reduce the postoperative pulmonary infection rate.
【作者单位】：温岭市第一人民医院麻醉科;
【基金】：浙江省科学技术厅基金资助项目(2010C33035)
【分类号】：R614;R735.2

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