肺癌手术患者不同自控镇痛方案发生肺部感染的分析  

Analysis of lung infections of patients with lung cancer after taking different self-control analgesia schemes

作　　者：陈洁[1] 王云[1] 刘德生[1] 赵文娟[1] 沈淼[1] 

机构地区：[1]青海省人民医院麻醉科,青海西宁810000

出　　处：《中华医院感染学杂志》2015年第20期4734-4736,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(30271259)

摘　　要：目的研究肺癌手术患者硬膜外与静脉自控镇痛对肺部感染的对比分析,为肺功能的恢复提供依据。方法选择2011年10月-2014年5月医院接诊的肺癌手术患者80例,随机将其分成静脉自控镇痛(PCIA)组和硬膜外自控镇痛(PCEA)组,每组各40例,PCEA组选用容量为100ml的自控镇痛(PCA)泵,在采用硬膜外麻醉复合全麻术后,置一导管在硬膜外接PCA泵处,持续镇痛,PCIA组将输液装置接在静脉穿刺一端,PCA泵接在另一端,持续镇痛。结果两组镇痛均有效,VAS评分PCEA组显著低于PCIA组,差异有统计学意义(P<0.05);PCEA组肺癌手术患者术后肺部感染率10.0%明显低于PCIA组的27.5%,差异有统计学意义(P<0.05);对两组患者肺癌手术后3、5d的肺部能力的各项参数进行对比分析,发现术后PCEA组的肺功能通气的最大量(MVV)、用力第一秒的呼出气体量(FEV1.0)、肺总量(TLC)及使力肺活量(FVC)水平均高于对照组,差异有统计学意义(P<0.05)。结论 PCEA降低肺癌手术患者肺部感染率较明显,且对术后患者疼痛水平的降低效果更加显著,并且对患者肺部功能各个指标回归正常更加有利。OBJECTIVE To study the incidence of pulmonary infections after taking different self‐control analgesia schemes so as to provide references for the recovery of lung functions .METHODS A total of 80 cases of lung cancer patients who received surgeries were chosen from Oct .2011 to May 2014 in our hospital ,and they were randomly divided into patient controlled intravenous analgesia （PCIA ） group and patient controlled epidural analgesia （PCEA） group ,with 40 cases in each group .PCEA group was treated with 100 ml of PCA pump ,using the com‐pound anesthesia epidural anesthesia and postoperatively putting a catheter in the epidural external PCA pump to continuously ease pain ..PCIA group used infusion device at one side of venipuncture site ,with PCA pump at the other side to continuously ease pain .RESULTS The analgesia in both groups was effective ,but PCEA group proved to have better efficacy than PCIA group in VAS scores .The difference was significant （P〈0 .05） .The re‐sults showed that the postoperative lung infection rate in PCEA group was 10 .0% ,which was significantly lower than the control group with 27 .5% （P〈0 .05） .Comparison of all indicators of lung functions at the 3rd and 5th day after surgeries indicated that MVV ,FEV1 .0 ,TLC and FVC levels of PCEA group were significantly higher than those of the control group （P〈0 .05） .CONCLUSION PCEA can better reduce lung infections in lung cancer patients with surgeries and can significantly lower the pain level of patients after operations .It is proved to be more favorable in returning indicators of lung functions to a normal level .

关 键 词：静脉自控镇痛 硬膜外自控镇痛 肺癌手术患者 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统]