肺癌手术患者不同自控镇痛方案发生肺部感染的分析

发布时间：2018-04-01 17:13

本文选题：静脉自控镇痛　切入点：硬膜外自控镇痛　出处：《中华医院感染学杂志》2015年20期

【摘要】：目的研究肺癌手术患者硬膜外与静脉自控镇痛对肺部感染的对比分析,为肺功能的恢复提供依据。方法选择2011年10月-2014年5月医院接诊的肺癌手术患者80例,随机将其分成静脉自控镇痛(PCIA)组和硬膜外自控镇痛(PCEA)组,每组各40例,PCEA组选用容量为100ml的自控镇痛(PCA)泵,在采用硬膜外麻醉复合全麻术后,置一导管在硬膜外接PCA泵处,持续镇痛,PCIA组将输液装置接在静脉穿刺一端,PCA泵接在另一端,持续镇痛。结果两组镇痛均有效,VAS评分PCEA组显著低于PCIA组,差异有统计学意义(P0.05);PCEA组肺癌手术患者术后肺部感染率10.0%明显低于PCIA组的27.5%,差异有统计学意义(P0.05);对两组患者肺癌手术后3、5d的肺部能力的各项参数进行对比分析,发现术后PCEA组的肺功能通气的最大量(MVV)、用力第一秒的呼出气体量(FEV1.0)、肺总量(TLC)及使力肺活量(FVC)水平均高于对照组,差异有统计学意义(P0.05)。结论 PCEA降低肺癌手术患者肺部感染率较明显,且对术后患者疼痛水平的降低效果更加显著,并且对患者肺部功能各个指标回归正常更加有利。
[Abstract]:Objective to study the effects of epidural analgesia (PCEA) on pulmonary infection in patients with lung cancer and to provide evidence for the recovery of lung function.Methods from October 2011 to May 2014, 80 patients with lung cancer received surgery in hospital were randomly divided into two groups: PCIA group and PCEA group. 40 patients in each group were treated with 100ml pump.After epidural anesthesia combined with general anesthesia, a catheter was placed at the place of epidural PCA pump. In the group of continuous analgesia, the infusion device was connected at one end of venipuncture to the other end for continuous analgesia.Results the scores of effective analgesia in PCEA group were significantly lower than those in PCIA group.It was found that the maximal volume of pulmonary function ventilation (MVV), the volume of forced exhalation (FEV 1.0), the total lung volume (TLC) and the vital capacity (AV) of the PCEA group were higher than those in the control group (P 0.05).Conclusion PCEA can significantly reduce the lung infection rate in patients with lung cancer, and it is more effective to reduce the postoperative pain level of patients with lung cancer, and it is more favorable for the patients to return to normal pulmonary function.
【作者单位】：青海省人民医院麻醉科;
【基金】：国家自然科学基金资助项目(30271259)
【分类号】：R734.2

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