麻醉及镇痛方式对胃癌患者术后下呼吸道感染的影响

The effect of anesthesia combinded with analgesia on lower respiratory tract infection

为观察单纯全身麻醉及术后静脉自控镇痛（PCIA）与硬膜外复合全身麻醉及术后硬膜外自控镇痛（PCEA）对胃癌患者术后下呼吸道感染的影响，选择ASAI～Ⅱ级胃癌患者48例，随机分为两组，每组24例。A组：手术时采用单纯全身麻醉，术后采用静脉自控镇痛（PCIA）；B组：手术时采用硬膜外复合全身麻醉，术后采用硬膜外自控镇痛（PCEA）。观察术后1～4d患者下呼吸道感染的情况。结果单纯全身麻醉及术后PCIA组和硬膜外复合全身麻醉及术后PCEA组胃癌患者术后下呼吸道感染率分别为29．2％（7／24）和12．5％（3／24），差异有统计学意义（x2=2．02，P〈0．05）。结果表明，行胃癌根治术患者选用硬膜外复合全身麻醉及术后PCEA能减少肺部感染的发生。

In order to observe the the effect of general anesthesia and postoperative intravenous analgesia compared with epidural anesthesia combined with general anesthesia on lower respiratory tract infection. ASA I -Ⅱlevel in anes thesia gastric cancer patients, 48 cases were randomly divided into two groups of 24 eases. Group A： a simple choice of anesthesia, analgesia use intravenous analgesia （PCIA） ; Group B： use of epidural anesthesia eombined with general anes thesia, postoperative epidural analgesia use analgesia （PCEA）. To observe the condition of lower respiratory tract infec tion after 1--4 days. After two groups of techniques, the lower respiratory tract infection percentage has the significance difference. The results indicated that after the gastric cancer root governing skill patient selects outside the epidural anes- thesia combined with general anesthesia and the technique, postoperative epidural analgesia use analgesia （PCEA）, can complications and so on effective prevention reduction lungs infection.