不同麻醉方式对上腹部手术老年患者肺部感染影响的临床研究

发布时间：2018-04-19 00:23

本文选题：肺部感染 + 麻醉　；参考：《中华医院感染学杂志》2015年07期

【摘要】：目的分析不同的麻醉方式对老年上腹部手术患者肺部感染的影响,为临床提供有效数据,探讨出一种比较安全、有效的麻醉方法,从而降低肺部感染发生率。方法选择2009年6月-2013年6月老年上腹部手术患者96例为研究对象,随机分为全麻复合硬膜外阻滞组(A组)、吸入麻醉组(B组)、全凭静脉全身麻醉组(C组),每组各32例,比较各组间的各项指标差异,采用SPSS15.0进行统计分析。结果 A组患者术后肺部感染率、苏醒时间及拔管时间分别为3.00%、(6.42±3.29)min、(12.26±6.38)min,B组患者分别为21.88%、(15.16±8.07)min、(22.45±10.23)min,C组患者分别为18.75%、(15.75±6.67)min、(22.09±10.34)min,其中,A组患者的术后肺部感染率分别低于B、C两组,差异有统计学意义(P0.05);比较3组患者在术后6h、1d、3d的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及T淋巴细胞亚群CD4+/CD8+比值:3组的IL-6和IL-8均比麻醉前有显著提高(P0.05)。结论采用硬膜外阻滞复合全麻有利于早期拔管,术后肺部感染率较低,有利于老年患者病情的恢复和缩短住院天数。
[Abstract]:Objective to analyze the effect of different anesthetic methods on lung infection in elderly patients undergoing upper abdominal surgery, to provide effective data for clinical use, and to explore a safe and effective anesthetic method to reduce the incidence of pulmonary infection.Methods Ninety-six elderly patients undergoing upper abdominal surgery from June 2009 to June 2013 were randomly divided into general anesthesia combined with epidural block group (group A), inhaled anesthesia group (group B) and intravenous general anesthesia group (group C), with 32 cases in each group.The differences of each index were compared, and SPSS15.0 was used for statistical analysis.Results the postoperative pulmonary infection rate, recovery time and extubation time in group A were 6.42 卤3.29 min and 12.26 卤6.38 min respectively, and were 21.88% in group B (15.16 卤8.07 min, 22.45 卤10.23 min), 18.75 卤6.67 min, 22.09 卤10.34 min, respectively. The postoperative pulmonary infection rate in group A was lower than that in group B (P < 0.05).The difference was statistically significant (P 0.05), the IL-6 and IL-8 of the three groups were significantly higher than that of the control group (P 0.05) and the ratio of T lymphocyte subsets CD4 / CD8: 3 was significantly higher than that of the control group on the 3rd day after operation (P < 0.05), and the ratio of T lymphocyte subsets to CD4 / CD8 was significantly higher than that of the control group (P < 0.05), which was significantly higher than that of the control group (P < 0.05).Conclusion epidural block combined with general anesthesia is beneficial to the early extubation and lower postoperative pulmonary infection rate. It is beneficial to the recovery of the disease and the shortening of hospital stay in the elderly patients.
【作者单位】：青海大学附属医院麻醉科;
【基金】：青海省卫生厅中青年医师扶持基金资助项目(QW-2010B-020)
【分类号】：R614

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