麻醉与镇痛方式对胃癌患者术后下呼吸道感染的影响

发布时间：2018-03-23 13:18

本文选题：麻醉与镇痛方式　切入点：胃癌患者术后　出处：《中华医院感染学杂志》2017年19期

【摘要】：目的分析不同麻醉与镇痛方式对胃癌患者术后下呼吸道感染的影响。方法选取医院2014年7月-2016年7月收治的200例胃癌患者为研究对象,随机分为甲组54例、乙组54例、丙组46例、丁组46例,四组患者术前诱导麻醉方式均相同,术中麻醉与术后镇痛方式分别为:甲组术中吸入麻醉药维持全身麻醉+术后静脉自控镇痛(PCVA);乙组术中吸入麻醉药维持全身麻醉+术后硬膜外自控镇痛(PCEA);丙组术中硬膜外复合全身麻醉+术后静脉自控镇痛(PCVA);丁组术中硬膜外复合全身麻醉+术后硬膜外自控镇痛(PCEA),分析患者下呼吸道感染情况、镇痛效果及血气指标。结果丁组下呼吸道感染率显著低于甲、乙、丙组,乙组及丙组感染率明显低于甲组(P0.05),但乙组与丙组比较差异无统计学意义;甲组与丙组、乙组与丁组VAS疼痛评分差异无统计学意义;乙、丁组VAS疼痛评分明显低于甲、丙组,差异有统计学意义(P0.05);甲组与乙组、丙组与丁组各项血气指标差异无统计学意义,但丙、丁组与甲、乙组差异有统计学意义(P0.05)。结论胃癌患者术中选择硬膜外复合全身麻醉方式以及术后硬膜外自控镇痛方式不仅能明显减少患者术后下呼吸道感染的发生率,同时减轻术后疼痛程度,提高患者术后生活质量,具有较高的临床参考价值。
[Abstract]:Objective to analyze the effect of different anesthetic and analgesic methods on lower respiratory tract infection in patients with gastric cancer after operation. Methods 200 patients with gastric cancer admitted in our hospital from July 2014 to July 2016 were randomly divided into group A (54 cases) and group B (54 cases). There were 46 cases in group C and 46 cases in group D. The methods of intraoperative anesthesia and postoperative analgesia were as follows: group A maintained intraoperative general anesthesia and postoperative intravenous controlled analgesia; group B received intraoperative inhalation of anesthetic to maintain postoperative epidural analgesia; group C received PCEA during operation. In group D, PCEA was used to control epidural analgesia after epidural combined general anesthesia, and to analyze the infection of lower respiratory tract in group D. Results the infection rate of lower respiratory tract in group D was significantly lower than that in group A, group B, group C, group B and group C was significantly lower than that in group A (P 0.05), but there was no significant difference between group B and group C. There was no significant difference in VAS pain score between Group B and Group D, the pain score of VAS in Group B and Group D was significantly lower than that in Group A and Group C, the difference was statistically significant (P 0.05), there was no significant difference in blood gas indexes between Group A and Group B, Group C and Group D, but there was no significant difference in blood gas index between Group A and Group B, Group C and Group D, Conclusion the choice of epidural combined general anesthesia and postoperative patient-controlled epidural analgesia can significantly reduce the incidence of lower respiratory tract infection in patients with gastric cancer. At the same time, the degree of postoperative pain relief, improve the quality of life of patients after surgery, has a higher clinical reference value.
【作者单位】：当阳市人民医院麻醉科;宜昌市中心人民医院麻醉科;三峡大学仁和医院麻醉科;
【基金】：湖北省科技攻关计划基金资助项目(2004AA301C49)
【分类号】：R614;R735.2

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