硬膜外自控镇痛对肺叶切除术后肺部感染患者的肺功能、应激指标及并发症的影响

发布时间：2018-10-23 15:35

【摘要】：目的观察硬膜外自控镇痛对于肺叶切除术后肺部感染病患的影响,分析镇痛方式对于肺叶切除术后肺部感染的干预效果。方法选择医院2013年11月-2016年4月择期行肺叶切除术后并发肺部感染的84例早期肺癌病患为观察病例,根据术后镇痛方法分成硬膜外自控镇痛(即硬膜外组)41例和静脉自控镇痛组(即静脉组)43例,观察手术前后病患肺功能、应激指标变化,对比两组镇痛效果和手术并发症情况。结果手术后相同时间点,硬膜外组VAS评分显著低于静脉组(P0.05);手术后,两组MVV、FEV1、FVC先降后升,与术前相比变化明显,但硬膜外组变化幅度显著低于静脉组(P0.05);术后两组IL-6、hs-CRP和PEG2先升后降且硬膜外组变换范围明显低于静脉组(P0.05);硬膜外组并发症发生率(26.83%)显著低于静脉组(46.51%),组间差异显著(P0.05)。结论硬膜外自控镇痛不仅镇痛效果显著,而且能够促进肺叶切除术后肺部感染病患肺功能恢复,而且对与应激性指标干扰更小。
[Abstract]:Objective to observe the effect of patient-controlled epidural analgesia on pulmonary infection after lobectomy and analyze the effect of analgesia on pulmonary infection after lobectomy. Methods Eighty-four patients with early lung cancer complicated by pulmonary infection after elective lobectomy in hospital from November 2013 to April 2016 were selected as observation cases. According to the method of postoperative analgesia, 41 cases of patient-controlled epidural analgesia (PCEA) and 43 cases of patient-controlled intravenous analgesia (PCEA) were divided into two groups. The pulmonary function and stress index were observed before and after operation, and the analgesic effect and complications were compared between the two groups. Results at the same time after operation, the VAS score of epidural group was significantly lower than that of intravenous group (P0.05). The change range of IL-6,hs-CRP and PEG2 in epidural group was significantly lower than that in intravenous group (P0.05); the change range of IL-6,hs-CRP and PEG2 in epidural group was significantly lower than that in venous group (P0.05); the incidence of complications in epidural group (26.83%) was significantly lower than that in intravenous group (46.51%), and the difference between groups was significant (P0.05). Conclusion PCEA not only has a significant analgesic effect, but also promotes the recovery of pulmonary function in patients with pulmonary infection after lobectomy, and has less interference with stress index.
【作者单位】：湖北民族学院附属民大医院重症医学科;湖北民族学院附属民大医院西药科;
【基金】：湖北省高等院校教学研究项目(KY201118)
【分类号】：R614;R734.2

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