全身麻醉复合硬膜外麻醉对胃癌根治术患者肺功能及术后肺部感染的影响

发布时间：2018-04-21 06:50

本文选题：全身麻醉复合硬膜外麻醉 + 胃癌根治术　；参考：《中华医院感染学杂志》2017年06期

【摘要】：目的分析全身麻醉复合硬膜外麻醉对胃癌根治术患者肺功能及术后肺部感染的影响。方法选择2014年1月-2015年12月在医院行胃癌根治术患者200例,分为观察组及对照组,观察组使用全身麻醉复合硬膜外麻醉,对照组使用单纯全身麻醉,比较两组患者围术期中各项肺功能指标,麻醉恢复时间,肺部感染率及肺部感染病原菌分布情况。结果与术前1天的基础值相比,术后第1、3天,对照组(MVV-VE)/FEV1及MVV/FEV1均显著降低,RV/TLC%显著升高,而观察组与术前基础值相比无明显变化;在术后相同时间点,观察组三项指标均优于对照组;与对照组相比,观察组患者麻醉恢复时间均明显缩短,术后肺部感染率明显降低,肺部感染患者的主要病原菌为革兰阴性菌,以铜绿假单胞菌及大肠埃希菌为主。结论胃癌根治术患者使用全身麻醉复合硬膜外麻醉对患者肺功能影响小,而且可降低术后肺部感染的发生率,利于患者预后。
[Abstract]:Objective to analyze the effects of general anesthesia combined with epidural anesthesia on lung function and postoperative pulmonary infection in patients with gastric cancer. Methods from January 2014 to December 2015, 200 patients with gastric cancer were divided into observation group and control group. The observation group was treated with general anesthesia combined with epidural anesthesia, and the control group with simple general anesthesia. The lung function indexes, anesthesia recovery time, pulmonary infection rate and the distribution of pathogenic bacteria in lung infection were compared between the two groups. Results compared with the baseline value of one day before operation, the MVV-VEP / FEV1 and MVV/FEV1 in the control group were significantly decreased on the 1st day after operation, while the RV / TLC% was significantly increased in the control group, but there was no significant change in the observation group compared with the baseline value before the operation, and at the same time after operation, there was no significant difference between the observation group and the preoperative basic value. Compared with the control group, the anesthesia recovery time of the patients in the observation group was significantly shortened, the pulmonary infection rate was significantly decreased after operation, and the main pathogenic bacteria in the patients with pulmonary infection were Gram-negative bacteria, and compared with the control group, the three indexes in the observation group were better than those in the control group. Pseudomonas aeruginosa and Escherichia coli were the main pathogens. Conclusion General anesthesia combined with epidural anesthesia has little effect on lung function and can reduce the incidence of postoperative pulmonary infection and is beneficial to the prognosis of patients with gastric cancer.
【作者单位】：长治医学院附属和济医院麻醉科;长治医学院附属和济医院普外科;
【基金】：山西省卫生厅医药科技计划基金资助(21052382)
【分类号】：R614;R735.2

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