不同麻醉方式对老年下肢骨折患者术后肺部感染发生率的影响

发布时间：2018-04-19 20:45

本文选题：麻醉方式 + 下肢骨折　；参考：《中华医院感染学杂志》2017年19期

【摘要】：目的研究不同麻醉方式对老年下肢骨折患者术后肺部感染的影响,以期为临床老年下肢骨折患者选择最佳麻醉方式提供参考。方法选取2012年1月-2015年1月间行下肢骨折手术的老年患者264例,根据术前会诊、患者及家属意愿选定的麻醉方案实施麻醉术。其中气管插管全身麻醉74例(A组),硬膜外麻醉122例(B组),68例行腰硬联合麻醉(C组);观察三组患者手术一般情况及呼吸功能相关指标及术后肺部感染的发生情况。结果三组患者在出血量、手术时间、疼痛评分与住院时间,差异无统计学意义。麻醉前,三组患者血氧饱和度(SpO_2)、呼吸速率(RR)、分钟通气量(MV)无显著差异,手术结束后A组与B组呼吸功能相关指标无显著差异,但C组与A组与B组相比,差异显著(P0.05)。A组术后肺部感染率8.11%,B组则为4.92%,C组则为2.94%。C组感染率显著低于A组与B组(P0.05)。结论老年下肢骨折患者选择腰硬联合阻滞麻醉,有助于患者术后改善呼吸功能并显著降低术后肺部感染的发生率。
[Abstract]:Objective to study the effect of different anesthetic methods on postoperative pulmonary infection in the elderly patients with lower limb fractures, in order to provide a reference for the best way to choose the best anesthesia for the elderly patients with lower limb fractures. Methods 264 elderly patients with lower limb fracture operation in January 2012 January were selected and selected according to the preoperative consultation, patients and their families' wishes. 74 cases of tracheal intubation general anesthesia (group A), 122 cases of epidural anesthesia (group B) and 68 cases of combined lumbar epidural anesthesia (group C) were performed. The general situation of operation and respiratory function related indexes and the incidence of postoperative pulmonary infection in the three groups were observed. Results the amount of bleeding, operation time, pain score and time of hospitalization were observed in the three groups. Before anesthesia, there was no significant difference in blood oxygen saturation (SpO_2), respiratory rate (RR) and minute ventilation (MV) in the three groups. There was no significant difference in the respiratory function between the A group and the B group after the operation, but the difference was significant (P0.05) in the C group and the A group (P0.05) in the postoperative lung infection rate of 8.11%, the B group 4.92%, and the C group. The infection rate of group C was significantly lower than that of group A and group B (P0.05). Conclusion the selection of combined spinal epidural anesthesia for the elderly patients with lower limb fracture can help the patients improve their respiratory function after operation and significantly reduce the incidence of postoperative pulmonary infection.

【作者单位】：金华市文荣医院麻醉科;
【基金】：浙江省卫生厅基金资助项目(kb2812)
【分类号】：R614

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