全身麻醉与神经阻滞麻醉对膝关节置换患者术后医院感染的影响分析

发布时间：2019-07-17 16:12

【摘要】：目的本文对全身麻醉与神经阻滞麻醉对膝关节置换患者术后医院感染的影响进行了简要的分析,针对患者半髋关节置换手术后的影响,对全身麻醉和周围神经阻滞麻醉这两种方式做了探讨和其临床的适用性。方法本文选择了2014年2月~2017年2月医院的120例患者做过行膝关节置换术的,将其分成了一、二两组,每组各60例,分别选用全身麻醉的方式(一组)和周围神经阻滞麻醉的方式(二组);分别从麻醉起效时间、阻滞完成时间、药物剂量及术后感觉恢复时间来记录和观察这两组患者的情况,手术过后还要对患者的感染情况及感染病原菌分布及药敏试验结果进行观察。结果一组无论是从麻醉起效时间、阻滞完成时间还是术后感觉恢复时间都比二组的时间短(P0.05),而二组的麻醉使用剂量相对于一组(P0.05)也是非常低的。其结果如下:一组感染率为11.2%,共分离菌株12株,革兰阳性菌48株;二组感染率为3.5%,共分离菌株21株,革兰阳性菌39株。结论这两组所培养出的革兰阴性菌的抗菌耐药性特别高,有的以达到100%,像喹诺酮类、氨基糖苷类、第三代头孢菌素等,还有一些相对敏感的药物,像阿米卡星、美罗培南、头孢哌酮/舒巴坦及亚胺培南等。而培养出的革兰阳性菌抗菌耐药的药物就是克林霉素、青霉素等,敏感的药物就是利福平、万古霉素及替考拉宁等等。
[Abstract]:Objective to analyze the effect of general anesthesia and nerve block anesthesia on hospital infection in patients with knee arthroplasty, and to explore the clinical applicability of general anesthesia and peripheral nerve block anesthesia in view of the effect of hemicap arthroplasty. Methods 120 patients who underwent knee arthroplasty from February 2014 to February 2017 were divided into two groups, 60 cases in each group. General anesthesia (group 1) and peripheral nerve block anesthesia (group 2) were used respectively. The patients in these two groups were recorded and observed from the onset time of anesthesia, the completion time of block, the dose of drugs and the time of postoperative sensory recovery, respectively. after the operation, the infection, the distribution of pathogenic bacteria and the results of drug sensitivity test were also observed. Results both the onset time of anesthesia, the completion time of block and the time of postoperative sensory recovery in the first group were shorter than those in the second group (P 0.05), and the dose of anesthesia in the two groups was also very low compared with the first group (P 0.05). The results were as follows: the infection rate of the first group was 11.2%, 12 strains were isolated and 48 strains were Gram-positive bacteria, the infection rate of the two groups was 3.5%, 21 strains were isolated and 39 strains were Gram-positive bacteria. Conclusion the antibacterial resistance of Gram-negative bacteria cultured in these two groups is particularly high, some of which reach 100%, such as quinolones, aminoglycosides, third-generation cephalosporins, and some relatively sensitive drugs, such as amikacin, meropenem, cefoperazone / sulbactam and imipenem. The resistant drugs of Gram-positive bacteria are clindamycin, penicillin and so on, and the sensitive drugs are rifampicin, vancomycin and teicoplanin.
【作者单位】：兰陵县大仲村镇中心卫生院;
【分类号】：R614

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