麻醉与镇痛方式对胃癌患者术后下呼吸道感染的影响分析  

Influence of anesthesia and analgesia methods on postoperative lower respiratory tract infections in gastric cancer patients

作　　者：朱民新 周根荣 魏玮 

机构地区：[1]浦江中医院麻醉科,浙江浦江322200

出　　处：《中华医院感染学杂志》2015年第2期427-429,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生基金资助项目(2013KYB237)

摘　　要：目的探讨胃癌患者手术时不同麻醉方式和术后不同镇痛方式对下呼吸道感染的影响,分析其不同效果。方法选取2012年3月-2014年3月在医院治疗的胃癌患者218例,根据患者的临床资料,分为A、B、C、D 4组,其中A组56例、B组68例、C组49例、D组45例,术前均采用同样的诱导麻醉,但4组术中麻醉方式和术后镇痛方式不同,其中A组术中吸入强化麻醉、术后吗啡肌内注射止痛;B组术中吸入强化麻醉、术后吗啡药泵止痛;C组术中静脉强化麻醉、术后吗啡肌内注射止痛;D组术中静脉强化麻醉、术后吗啡药泵止痛。结果 A组术后感染5例,感染率为8.3%;B组术后感染3例,感染率为4.4%;C组术后感染11例,感染率为22.4%;D组术后感染8例,感染率为17.7%;4组间感染率的差异有统计学意义(P<0.05)。结论术中不同麻醉方式和术后不同镇痛方式严重影响患者下呼吸道感染率,且术中吸入麻醉+术后药泵止痛能有效减少胃癌患者术后下呼吸道感染的概率。OBJECTIVE To explore the influence of different anesthesia and analgesia methods on the postoperative lower respiratory tract infections in the gastric cancer patients and analyze the effects.METHODS A total of 218 gastric cancer patients who were treated in the hospital from Mar 2012 to Mar 2014 were enrolled in the study and divided into the group A with 56 cases,the group B with 68 cases,the group C with 49 cases,and group D with45 cases according to the clinical data;all the patients received the same induction anesthesia before the surgery,however,the four groups varied in the intraoperative anesthesia and the postoperative analgesia;the group A was treated with enhanced intraoperative inhalation anesthesia plus postoperative intramuscular injection of morphine for analgesia,the group B was treated with enhanced intraoperative anesthesia plus postoperative morphine analgesic drug pumps,the group C was treated with enhanced intraoperative intravenous anesthesia plus postoperative intravenous intramuscular injection of morphine for analgesia,and the group D was treated with enhanced intraoperative intravenous anesthesia plus postoperative morphine analgesic drug pumps.RESULTS The postoperative infection occurred in 5（8.3%）cases in the group A,3（4.4%）cases in the group B,11（22.4%）cases in the group C,8（17.7%）cases in the group D,there was significant difference in the infection rate between the four groups（P〈0.05）.CONCLUSION The different intraoperative anesthesia methods and postoperative analgesia methods can significantly influence the incidence of lower respiratory tract infections,and the intraoperative inhalation anesthesia plus postoperative analgesic drug pumps can effectively reduce the possibility of lower respiratory tract infections in the gastric cancer patients.

关 键 词：麻醉及镇痛 胃癌 下呼吸道感染 影响分析 

分 类 号：R619.3[医药卫生—外科学]