不同麻醉方式对老年食管癌手术患者术后肺部感染的影响

发布时间：2018-07-24 20:02

【摘要】：目的探讨不同麻醉方式对老年食管癌手术患者术后肺部感染及炎症反应的影响,为临床行颈-胸-腹部三切口食管癌根治术的患者麻醉药物的选择提供参考。方法选取医院于2014年1月-2016年12月行全身麻醉下行颈-胸-腹部三切口食管癌根治术的230例患者,采用随机数字表分为丙泊酚组(P组)和七氟烷组(S组),每组各115例;统计分析两组单肺通气前后的通气侧及塌陷侧两肺支气管上皮内衬液(ELF),并比较两组患者炎性指标和临床指标。结果在通气侧及非通气侧ELF内,单肺通气后,P组白介素-6(IL-6)、白介素-8(IL-8)较单肺通气前均降低,而S组IL-6、IL-8较单肺通气前均升高(P0.05);S组及P组白介素-10(IL-10)含量均高于单肺通气前(P0.05);S组肺部感染发生率为13.9%高于P组的6.1%(P0.05)。结论与七氟烷相比,丙泊酚能够抑制行食管癌根治术的老年患者术后肺部炎症反应,降低肺部感染发生率,改善此类患者预后,在临床麻醉药物选择中应予以重视。
[Abstract]:Objective to investigate the effects of different anesthetic methods on postoperative pulmonary infection and inflammatory response in elderly patients with esophageal cancer surgery, and to provide a reference for the selection of anesthetics for patients undergoing radical resection of cervical thoracic and abdominal three incisions. Methods a hospital in December, January 2014 -2016, under general anesthesia for cervical thoracic and abdominal three incision esophagus cancer was selected. 230 patients with radical mastectomy were divided into the propofol group (group P) and the seven halothane group (group S), 115 cases in each group, and the two groups of lung and collapse side two lung bronchial epithelial lining fluid (ELF) were statistically analyzed in two groups before and after single lung ventilation, and the inflammatory markers and clinical indexes were compared in the two groups. The results were in the ventilated and non ventilated side ELF, single lung. After ventilation, interleukin -6 (IL-6) and interleukin -8 (IL-8) in group P were lower than that before lung ventilation, while IL-6 and IL-8 in group S were higher than that before lung ventilation (P0.05), and the levels of interleukin -10 in S and P were higher than that before one lung ventilation. The incidence of pulmonary infection was 13.9% higher than that of 6.1%. Conclusion propofol could be suppressed compared with seven halothane. The postoperative pulmonary inflammatory reaction in the elderly patients with radical esophagectomy can reduce the incidence of pulmonary infection and improve the prognosis of these patients. It should be paid attention to in the selection of clinical anesthetics.
【作者单位】：浙江省肿瘤医院麻醉科;
【基金】：浙江省医学会临床科研基金资助项目(2015ZYC-A113)
【分类号】：R614;R735.1

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