不同麻醉方案下结直肠癌患者的肺部感染状况对比  

Comparison of pulmonary infection in patients with colorectal cancer under different anesthesia

作　　者：单汉民[1] 徐文丽[2] 刘洋[1] 吴鹤芬[1] SHAN Han-min XU Wen-li LIU Yang WU He-feng(Huzhou Central Hospital, Huzhou, Zhejiang 313000, China)

机构地区：[1]湖州市中心医院麻醉科,浙江湖州313000 [2]湖州市中心医院检验科,浙江湖州313000

出　　处：《中华医院感染学杂志》2017年第7期1590-1593,共4页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅医药科技计划(201622331)

摘　　要：目的探讨不同麻醉方案下结直肠癌患者的肺部感染情况,为临床合理选择麻醉方案提供参考依据。方法选取2013年1月-2016年3月在医院治疗的结直肠癌患者183例为研究对象,根据不同的麻醉方案分为A组(静脉全麻组)92例和B组(硬膜外阻滞复合全麻)91例,比较两组患者临床指标及病原菌分布。结果 B组患者的麻醉时间、手术时间、术中出血量及术后苏醒时间均低于A组患者(P<0.05);A组患者发生肺部感染11例,感染率11.96%,B组患者发生肺部感染3例,感染率3.30%;B组患者肺部感染率低于A组患者,差异有统计学意义(P<0.01);两组患者肺部感染病原菌均以革兰阴性菌为主,分别为9株和3株,A组患者病原菌分布与B组患者比较,差异均无统计学意义。结论硬膜外阻滞复合全麻可减少患者术中出血量、缩短术后苏醒时间,减少肺部感染率,更加适合于结直肠癌手术患者。OBJECTIVE To investigate the pulmonary infection in patients with colorectal cancer under different an- esthesia, so as provide a reasonable basis for clinical selection of anesthesia. METHODS A total of 183 cases of colorectal cancer patients treated in our hospital from Jan. 2013 to Mar. 2016 were selected. According to differ- ent anesthesia methods, they were divided into group A （intravenous anesthesia group, 92 cases） and group B （epidural block combined with general anesthesia, 91 cases）. The clinical indexes and pathogenic bacteria distribu- tion of the two groups were compared. RESULTS The anesthesia time, operation time, intraoperative bleeding and postoperative recovery time of group B were lower than those of group A （P〈0.05）. There were 11 cases of pul- monary infection occurred in group A, with the infection rate of 11.96%, and 3 cases in group B, with the infec- tion rate of 3.30%. The incidence of pulmonary infection in patients of group B was significantly lower than that of group A （P〈0.01）. The pathogens in two groups of patients with pulmonary infection were mainly gram-nega- tive bacteria, which were respectively 9 and 3 strains in group A and group B. The distribution of pathogenic bac- teria in group A was not statistically different from that in group B. CONCLUSION Epidural block combined with general anesthesia can reduce the intraoperative bleeding amount, shorten the postoperative recovery time, and re- duce the pulmonary infection rate, which is more suitable for patients with colorectal cancer surgery.

关 键 词：麻醉 结直肠癌 肺部感染 

分 类 号：R563.1[医药卫生—呼吸系统]