不同麻醉方案对髋关节置换术老年患者下呼吸道感染的影响研究

发布时间：2018-04-21 13:12

本文选题：气管插管麻醉 + 椎管内麻醉　；参考：《中华医院感染学杂志》2016年04期

【摘要】：目的探讨不同麻醉方案对髋关节置换术老年患者下呼吸道感染影响,为降低下呼吸道感染提供依据。方法选取2014年1月-2015年1月在医院就诊的54例髋关节置换术老年患者,按照随机数表法分组,其中26例实施气管插管麻醉法患者作为气管插管麻醉组,其中的28例实施椎管内麻醉法患者作为椎管内麻醉组;留取两组患者下呼吸道黏膜标本,检测病原菌,统计两组患者的相关指标进行比较。结果气管插管麻醉组患者下呼吸道感染率为11.5%,明显高于椎管内麻醉组患者的3.6%,差异有统计学意义(P0.05);气管插管麻醉组患者标本中检出病原菌82株,椎管内麻醉组患者标本中检出病原菌45株;手术后T淋巴细胞中迟发型变态反应T细胞(TD)、CD4+T细胞、细胞毒性T细胞(TC)含量气管插管麻醉组分别为55.2%、30.1%、17.2%,椎管内麻醉组分别为54.3%、31.3%、18.4%,两组患者的T淋巴细胞比较,差异无统计学意义;两组患者手术后吞噬细胞、自然杀伤细胞(NK细胞)差异有统计学意义(P0.05)。结论气管插管麻醉法较椎管内麻醉法更容易导致患者发生下呼吸道感染。
[Abstract]:Objective to investigate the effect of different anesthetic schemes on lower respiratory tract infection in elderly patients undergoing hip arthroplasty, and to provide evidence for reducing lower respiratory tract infection. Methods from January 2014 to January 2015, 54 elderly hip arthroplasty patients were divided into two groups according to random number method, 26 of whom were treated with tracheal intubation anesthesia as tracheal intubation anesthesia group. Among them 28 cases were treated with intraspinal anesthesia as the spinal canal anesthesia group and the lower respiratory mucosa specimens were collected from the two groups to detect the pathogenic bacteria and to compare the related indexes of the two groups. Results the infection rate of lower respiratory tract in tracheal intubation anesthesia group was 11.5, which was significantly higher than that in intraspinal anesthesia group (3.6%), the difference was statistically significant (P 0.05), and 82 strains of pathogenic bacteria were detected in tracheal intubation anesthesia group. 45 strains of pathogenic bacteria were detected in spinal canal anesthetic group, and T cells of delayed allergic reaction T cell (TDX) CD4 T cell were detected in T lymphocytes after operation, the results were as follows: (1) in the spinal canal anesthesia group, 45 strains of pathogenic bacteria were detected. The contents of cytotoxic T cell TCC in tracheal intubation anesthesia group were 55.2 and 30.1and 17.2respectively, and those in spinal canal anesthesia group were 54.3 and 31.3g respectively. There was no significant difference in T lymphocytes between the two groups. The difference of NK cells in natural killer cells was statistically significant (P 0.05). Conclusion tracheal intubation anesthesia is more likely to cause lower respiratory tract infection than intraspinal anesthesia.
【作者单位】：聊城市中医医院麻醉科;聊城市东昌府人民医院麻醉科;聊城市脑科医院药房;聊城市人民医院检验科;聊城市人民医院皮肤科;
【基金】：山东省科技厅基金资助项目(Z-2014-1-3-46-1)
【分类号】：R614

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