吸入麻醉药与异丙酚对结直肠手术患者术后手术部位感染的影响  

Effects of inhalation anesthesia and propofol on postoperative surgical site infections in patients with colorectal surgery

作　　者：张彩举[1] 杨帆[2] 付金厚[1] 刘建[1] 李之明 马磊[4] ZHANG Cai-ju;YANG Fan;FU Jin-hou;LIU Jian;LI Zhi-ming;MA Lei(Nanyang First Peoplets Hospital, Nanyang, Henan 473000, Chin)

机构地区：[1]南阳市第一人民医院麻醉科,河南南阳473000 [2]南阳市第一人民医院病案管理科,河南南阳473000 [3]清华大学第一附属医院麻醉科,北京100015 [4]南阳市第一人民医院肿瘤科,河南南阳473000

出　　处：《中华医院感染学杂志》2018年第3期406-409,共4页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划基金资助项目(2014073346)

摘　　要：目的探讨吸入麻醉药与异丙酚对结直肠手术后外科手术部位感染的影响。方法选取医院2013年2月-2016年3月结直肠疾病患者128例,分为试验组和对照组,各64例。试验组采用异丙酚麻醉,对照组采用吸入麻醉药,例如七氟烷。比较两组患者麻醉效果、手术部位感染分布和白细胞介素-6(IL-6)及T淋巴细胞亚群数量。结果试验组患者自主呼吸恢复时间、睁眼时间、拔管时间和应答时间分别为(7.09±3.20)min、(11.58±4.30)min、(12.50±3.40)min和(16.00±4.52)min短于对照组(11.30±2.95)min、(18.90±4.22)min、(19.84±3.57)min、(26.01±4.09)min(P<0.05)。试验组手术部位感染率4.69%低于对照组12.50%,(P<0.05)。试验组术后1d,IL-6、CD_3^+、CD_4^+、CD_4^+/CD8+分别为(82.40±5.30)pg/ml、(51.00±3.15)%、(27.02±1.04)%、(1.22±0.29)与对照组的(101.00±8.34)pg/ml、(42.00±3.20)%、(23.03±2.10)%、(1.04±0.71)比较,差异有统计学意义(P<0.05)。结论麻醉剂与结直肠手术患者术后手术部位感染具有一定相关性,而加强麻醉剂与结直肠手术后外科手术部位感染对比研究,有助于选取合理麻醉剂降低对机体功能的干扰,控制手术部位感染,促进切口的早期愈合。OBJECTIVE To explore the effects of inhaled anesthetics and propofol on surgical site infections after colorectal surgery.METHODS In the hospital, 128 patients with monthly statement rectal disease were selected from Feb. 2013 to Mar. 2016, and were randomly divided into observation group and control group, with 64 cases in each group. The observation group adopted propofol anesthesia, and the control group adopted inhaled anesthet- ics, such as sevoflurane. The anesthesia effect, surgical site infection distribution and interleukin-6 （IL-6） and T lymphocyte subgroups were compared between the two groups.RESULTS The spontaneous respiration time, open- eye time, extubation time and response time of observation group were （7.09±3.20） min, （11.58±4.30） min, （12.50±3.40） min and （16.00±4.52） min, which were shorter than （11.30±2.95）min, （18.90±4.22）min （19. 84±3.57）min and （26.01±4.09）min of control group（P〈0.05）.The operative site infection rate of observation group was 4.69%, which was lower than 12.50% of control group, and the difference was significant （P〈0.05）. The level of IL-6, CD3＋ , CD4＋ and CD4＋/CD8＋ of observation group at 1 day after operation were （82.40±5. 30） pg/ml, （51.00± 3.15）%, （27.02± 1.04）± and （1.22±0.29）, which had significant differences compared with （101.00±8.34）pg/ml, （42.00±3.20）%, （23.03±2.10）% and （1.04±0.71） of eontrol group （P〈0.05）.CONCLUSION Anesthesia and postoperative surgical site infections in patients with colorectal surgery has a certain relevance, and strengthening the contrast research of anesthetic and surgical site infections after colorectal surgery, can help to select reasonable anesthetic to reduce the interference with the body function, control of surgical site infections, and promote healing of incision of the early.

关 键 词：结直肠 手术 部位 感染 麻醉剂 

分 类 号：R619.3[医药卫生—外科学]