不同麻醉方法对老年食管癌患者术后肺部感染的影响.pdf

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1、中华医院感染学杂志2013年第23卷第1O期ChinJNosocomi0lVo1．23No．102013-2337·论著不同麻醉方法对老年食管癌患者术后肺部感染的影响朱东兴，戴平(1．诸暨市妇幼保健院麻醉科，浙江诸暨311800；2．诸暨市人民医院麻醉科，浙江诸暨311800)摘要：目的探讨不同麻醉方法对老年食管癌患者术后肺部感染的影响，为预防肺部感染提供参考。方法选择140例择期老年食管癌手术患者，随机分为胸段硬膜外阻滞复合静脉全麻+术后自控硬膜外镇痛组(A组)和全凭静脉麻醉+术后自控静脉镇痛(B组)，每组各7O例；两组患

2、者分别在麻醉前、拔管后5rain2个时相监测呼吸功能变化：呼吸频率(RR)、血氧饱和度(SpOz)、分钟通气量(MV)；术毕停药后观察两组患者自主呼吸恢复时间、呼之睁眼时间、拔管时间，并于术后第3天监测两组患者有无发热、咳嗽咳痰、肺部哕音、白细胞>15×10。／L，检查胸部x线片，比较两组患者肺部感染的发生率。结果B组患者拔管后RR、MV、SpO较麻醉前有较显著的变化(P

3、管时间均明显短于B组患者(P38℃)、咳嗽咳痰、肺部罗音、白细胞>15×1O。／L、胸片见炎症改变及肺部感染发生率，均明显低于对照组(P

4、methodsonpostoperativepulmonaryinfectionsinelderlypatientswithesophaguscancerZHUDong—xing。DAIPing(*MaternalandChildHealthHospital，Zhi，Zhejiang311800，China)Abstract：OBJECTIVEToinvestigatetheeffectsofdifferentanesthesiamethodsonpostoperativepulmonaryinfectionsintheel

5、derlypatientswithesophaguscancersoastoprovidebasisforthepreventionofpulmonaryinfections．METHODSAtotalof140elderlypatientswhounderwenttheselectivelobectomyforesophaguscancerwererandomlydividedintotwogroupswith70casesineach．InthegroupA，thepatientsreceivedgeneralanest

6、hesiacombinedwiththoracicepiduralanesthesiaduringsurgeryandreceivedepiduralanalgesia；thepatientsinthegroupBreceivedgeneralanesthesiaandintravenousanalgesiapostoperatively．Therespiratoryfunction(RR，MV，SpO2)wereobtainedatthefollowingtimepoints：beforetheinductionofane

7、sthesia，5minaftertheextubation．Thetimeofbreathing，openingeyes，andextubationweremonitoredinthetwogroups．Onthethirdafterthesurgery，thefever，productivecough，pulmonaryrale，whitebloodcellcount(>15×10／L)，andchestX-rayweremonitored，andtheincidenceofthepulmonaryinfectionsw

8、erecomparedbetweenthetwogroups．RESULTSTherewassignificantdifferenceintheRR，MVorSpOzofthegroupBbetweenbeforetheinductionofanesthesiaand5minafterex