不同麻醉方式对骨科术后老年患者感染的影响研究

发布时间：2018-08-06 20:24

【摘要】：目的探讨不同麻醉方式对骨科术后老年患者感染的影响。方法选取2015年3月-2016年10月医院收治的老年骨科手术患者200例,根据麻醉方式的不同,分为A组66例,B组74例,C组60例,其中A组行气管插管全身麻醉,B组行硬膜外麻醉,C组行腰硬联合麻醉,回顾性分析三组患者术后恢复情况,并对三组术后感染部位分布情况、三组不同时间内血浆白细胞介素-6/白细胞介素-10(IL-6/IL-10)比值情况进行对比分析。结果 A组感染率为18.18%明显高于B组6.76%、C组5.00%,差异有统计学意义(P0.05);所有患者麻醉前、手术结束时、术后24~48h,其IL-6/IL-10比值均呈逐渐递增的趋势增加,A组术后24~48h的IL-6/IL-10值(10.94±8.52)明显高于B组(7.88±4.52)、C组(7.04±3.57),差异有统计学意义(P0.05)。结论气管插管全身麻醉不利于高龄患者使用,为了减少院内感染,提高手术治疗疗效,建议使用硬膜外麻醉或腰硬联合的麻醉方式。
[Abstract]:Objective to investigate the effect of different anesthetic methods on infection in elderly patients after orthopedic surgery. Methods from March 2015 to October 2016, 200 elderly orthopedic patients were selected and divided into group A (66 cases), group B (74 cases) and group C (60 cases) according to the different anesthetic methods. Group A was given endotracheal intubation and group B was given epidural anesthesia and group C was given combined spinal epidural anesthesia. The recovery of the patients in the three groups was analyzed retrospectively, and the distribution of infection sites in the three groups was analyzed. The ratio of plasma interleukin-6 / interleukin-10 (IL-6/IL-10) in three groups was compared. Results the infection rate in group A was 18.18% higher than that in group B (6.76% vs 5.00), the difference was statistically significant (P0.05), before anesthesia and at the end of operation, the infection rate in group A was significantly higher than that in group C (P 0.05). The IL-6/IL-10 ratio of group A (10.94 卤8.52) was significantly higher than that of group B (7.88 卤4.52) and group C (7.04 卤3.57) (P0.05). Conclusion General anesthesia with tracheal intubation is not good for the elderly patients. In order to reduce nosocomial infection and improve the curative effect of surgery, epidural anesthesia or combined spinal-epidural anesthesia is recommended.
【作者单位】：宁波市镇海区人民医院麻醉科;宁波市镇海区人民医院骨科;
【基金】：宁波市卫生局基金资助项目(201606336)
【分类号】：R614

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