不同麻醉方法对老年十二指肠胰头癌患者术后肺部感染影响的临床研究  

Clinical studies on different methods of anesthesia in elderly patients with duodenal pancreatic cancer combined with lung infection after operation

作　　者：张明途[1] 徐位芸[1] 汤秋芳[2] 章仲恒[2] 

机构地区：[1]金华市中心医院麻醉科,浙江金华321000 [2]金华市中心医院重症医学科,浙江金华321000

出　　处：《中华医院感染学杂志》2014年第24期6177-6178,6184,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(ZW-2010B-032)

摘　　要：目的探讨不同麻醉方法对老年十二指肠胰头癌患者术后肺部感染影响性,以寻找最佳麻醉方法,降低术后肺部感染发生率。方法选取2010年4月-2013年4月70例老年十二指肠胰头癌手术患者为研究对象,分成两组,每组各35例,对照组予以全凭静脉麻醉,观察组予以胸段硬膜外阻滞复合静脉全麻,术后均予以自控静脉镇痛,比较两组在相关指标上的差异,采用SPSS16.0进行软件分析。结果观察组拔管后5 min呼吸频率(RR)、血氧饱和度(SpO2)、通气量(MV)分别为(21.05±4.67)/min、(98.01±0.43)%、(8.62±0.28)L:对照组分别为(27.47±6.42)/min、(87.35±1.28)%、(6.37±4.58)L:两组上述指标比较差异有统计学意义(P<0.05);对照组肺部感染发生率17.14%,观察组肺部感染发生率5.71%,两组比较差异有统计学意义(P<0.05)。结论胸段硬膜外阻滞复合静脉全麻联合自控静脉镇痛可降低老年十二指肠胰头癌患者术后肺部感染发生率。OBJECTIVE To explore the effect of different methods of anesthesia on elderly patients with duodenal pancreatic cancer combined with lung infection after the operation ,so as to find the best anesthesia method to reduce the incidence of postoperative pulmonary infection .METHODS From Apr .2010 to Apr .2013 ,a total of 70 cases of elderly patients with duodenal pancreatic cancer surgery were selected as the study objects .They were di‐vided into two groups with 35 patients for each .The control group was given total basic anesthesia ,the observa‐tion group received general anesthesia with epidural block and both groups were treated with patient‐controlled in‐travenous analgesia The differences in the two groups on related indicators were compared .SPSS 16 .0 was adopt‐ed for a statistical analysis .RESULTS The respiratory frequency （RR） ,oxygen saturation （SpO2 ） ,ventilation （MV） of the observation group after extubation in five minutes were （21 .05 ± 4 .67）/min ,（98 .01 ± 0 .43）% , （8 .62 ± 0 .28） L ;in the control group ,they were （27 .47 ± 6 .42）/min ,（87 .35 ± 1 .28）% ,（6 .37 ± 4 .58） L ,the difference was significant （P＆lt;0 .05） ;the incidence of pulmonary infection in the control group was 17 .14% and the incidence of pulmonary infection in the observation group was 5 .71% ,the difference was significant （P＆lt;0 .05） .CONCLUSION Thoracic epidural anesthesia combined with controlled intravenous analgesia may reduce in‐cidence of postoperative pulmonary infection in elderly patients with duodenal pancreatic cancer .

关 键 词：老年患者 十二指肠胰头癌 肺部感染 麻醉方式 

分 类 号：R563[医药卫生—呼吸系统]