全身麻醉复合硬膜外麻醉对老年腹部手术患者术后肺部感染及肺功能的影响

发布时间：2018-05-24 14:03

本文选题：全身麻醉 + 硬膜外麻醉　；参考：《中国老年学杂志》2017年09期

【摘要】：目的探讨全身麻醉复合硬膜外麻醉对老年腹部手术患者术后肺部感染及肺功能的影响。方法选取拟行全身麻醉复合硬膜外麻醉下腹部手术的患者200例,根据年龄分组,≥60岁者82例为老年组,年龄60岁者118例为非老年组,均在全身麻醉复合硬膜外麻醉下行手术治疗,观察麻醉及手术相关指标、术后住院期间肺部感染,术前、术后3 d时第1秒用力呼气量(FEV1)、每分钟最大通气量(MVV)、残气量(RV)、肺总量(TLC)、每分静息通气量(VE)变化。结果两组患者麻醉时间、术后苏醒时间、拔管时间、手术时间、术中出血量比较差异无统计学意义(P0.05);老年组术后肺部感染率为21.95%,明显高于非老年组6.78%(P0.05);术后3 d时老年组(MVV-VE)/FEV1、MVV/FEV1、RV/TLC均较术前下降(P0.05),术后3 d时非老年组以上指标与术前比较无明显变化(P0.05),术后3 d时老年组以上指标明显低于非老年组(P0.05)。结论全身麻醉复合硬膜外麻醉对老年腹部患者术后肺功能影响较非老年人明显,术后肺部感染的发生率高于非老年人群。
[Abstract]:Objective to investigate the effects of general anesthesia combined with epidural anesthesia on pulmonary infection and pulmonary function in elderly patients undergoing abdominal surgery. Methods A total of 200 patients undergoing general anesthesia combined with epidural anesthesia for lower abdominal surgery were selected. According to the age group, 82 patients aged more than 60 years old were divided into elderly group and 118 patients aged 60 years were non-elderly group. All patients were treated with general anesthesia combined with epidural anesthesia. The indexes of anesthesia and operation were observed. Forced expiratory volume (FEV1), maximal ventilation volume (MVV1), residual volume (RV), total lung volume (TLCV) and resting ventilation volume (VEV) were observed 3 days after operation. Results the anesthesia time, postoperative recovery time, extubation time and operation time were observed in the two groups. The postoperative pulmonary infection rate in the elderly group was 21.95, which was significantly higher than that in the non-elderly group (6.78 / 0.05), and the RV / TLC of MVV-VEP / FEV _ 1 / FEV _ 1 / FEV _ 1 / RV _ 1 / TLC in the elderly group was significantly lower than that in the preoperative group 3 days after operation. At 3 days after operation, the above indexes in the elderly group were significantly lower than those in the non-elderly group. Conclusion the effect of general anesthesia combined with epidural anesthesia on postoperative pulmonary function in elderly patients with abdomen is more obvious than that in non-elderly patients, and the incidence of postoperative pulmonary infection is higher than that of non-elderly people.
【作者单位】：内蒙古科技大学包头医学院第一附属医院麻醉科;
【分类号】：R614

【相似文献】