不同麻醉方式对老年手术患者术后感染率及疼痛状态的影响比较  

Influence of anesthesia approaches on incidence of postoperative infections and pain state of elderly patients

作　　者：刘喆[1] 周勇[1] 张军[1] 高项羽[1] 李铮[1] 李丰[1] 

机构地区：[1]南阳市中心医院麻醉科,河南南阳473000

出　　处：《中华医院感染学杂志》2017年第1期172-174,共3页Chinese Journal of Nosocomiology

基　　金：河南省卫生厅资助项目(201401027)

摘　　要：目的探讨不同麻醉方式对老年手术患者术后感染发生及疼痛状态的影响,以寻找更合适老年手术患者的麻醉方式。方法收集医院2013年1月-2015年1月骨科及肿瘤科收治300例行手术治疗患者,分为3组各100例,A组给予吸入强化全麻,B组给予静脉强化全麻,C组给予硬膜外麻醉;观察三组患者手术后至拆线前感染情况,包括感染部位及感染例数;术后0、6、12、24、48h视觉模拟疼痛(VAS)评分,以了解术后不同时间患者疼痛情况;同时观察三组患者麻醉相关并发症发生情况。结果 A组术后15例发生感染,B组术后10例发生感染,C组术后3例发生感染,C组术后感染率低于其他两组(P<0.05);感染部位发生率对比,差异无统计学意义;三组术后0hVAS评分对比,差异无统计学意义,术后6、12、24hVAS评分均高于同组术后0h(P<0.05),三组术后同期组间两两对比,差异均无统计学意义;三组术后均未见严重麻醉相关并发症,C组麻醉相关并发症发生率低于A、B组(P<0.05)。结论老年手术患者选择硬膜外麻醉,可降低术后感染及疼痛状态,是老年患者理想选择。OBJECTIVE To explore the influence of different anesthesia approaches on incidence of postoperative in- fections and pain state of elderly patients so as to seek more appropriate anesthesia approach for the elderly pa- tients. METHODS A total of 300 patients who underwent surgeries in orthopedics department and oncology depart- ment from Jan 2013 to Jan 2015 were enrolled in the study and divided into three groups, with 100 cases in each group. The group A was treated with inhalation intensive general anesthesia, the group B was given intravenous intensive general anesthesia, and the group C was treated with epidural anesthesia. The prevalence of postoperative infections was observed and compared among the three groups of patients, including the infection sites and number of infection cases. The visual analogue scale （VAS） score was observed after the surgeries for 0, 6, 12, 24, and 48 hours so as to understand the postoperative pain state of the patients; the incidence of anesthesia-related complica- tions was observed and compared among the three groups. RESULTS The postoperative infections occurred in 15 cases in the group A, 10 cases in the group B, 3 cases in the group C; the incidence of postoperative infections was lower in the group C than in other two groups （P〈0.05）; there was no significant difference in the incidence of different sites of infections. There was no significant difference in the VAS score among the three groups after the surgery for 0 hour; the VAS score was higher after the surgery for 6, 12, and 24 hours than after the surgery for 0 hour （P〈0.05）, there was no significant difference in the VAS score among the three groups during the same period after the surgery. The severe anesthesia-related complications were not found in the three groups after the surgery; the incidence of anesthesia-related complications was lower in the group C than in the group A and the group B （P〈0.05）. CONCLUSION The epidural anesthesia can reduce the incidence of postoperative infections

关 键 词：麻醉方式 老年手术 术后感染 疼痛 

分 类 号：R619.3[医药卫生—外科学]