麻醉及镇痛方式对胃癌患者术后下呼吸道感染的影响分析

Influence of anesthesia and analgesia on postoperative lower respiratory tract infections in gastric cancer patients

目的分析不同麻醉及镇痛方式对胃癌患者术后下呼吸道感染的影响,探讨有效的方法降低呼吸道感染率。方法选取2010年5月-2014年5月医院手术胃癌患者86例,随机分为A、B两组,各43例;A组患者给予单纯全麻醉及术后静脉自控镇痛(PCIA),B组给予硬膜外复合全身麻醉及术后硬膜外自控镇痛(PCEA),比较两组患者的呼吸道感染率,数据采用SPSS 19.0软件进行统计分析。结果 A组VAS评分为(0.98±0.34)分,呼吸道感染率为32.56%;B组VAS评分为(0.97±0.35)分,呼吸道感染率为13.95%,经统计检验,两组镇痛效果差异无统计学意义,但B组感染率明显低于A组,差异有统计学意义(P<0.05);共检出20株病原菌,以白色假丝酵母菌为主,共5株占25.00%。结论与单纯全麻醉及术后静脉自控镇痛相比,硬膜外复合全身麻醉及术后硬膜外自控镇痛可以降低胃癌患者术后呼吸道感染率,值得临床推广。

OBJECTIVE To observe the effects of different anesthesia and analgesia methods on postoperative lower respiratory tract infections in the gastric cancer patients and put forward effective measures so as to reduce the in‐cidence of respiratory tract infections .METHODS A total of 86 gastric cancer patients who underwent surgeries from May 2010 to May 2014 were enrolled in the study and randomly divided into the group A and the group B , with 43 cases in each .The group A was treated with single general anesthesia and postoperative controlled intrave‐nous analgesia （PCIA） ,while the group B was given the epidural general anesthesia and postoperative controlled epidural analgesia （PCEA） .The incidence of respiratory tract infections was observed and compared between the two groups of patients ,and the statistical analysis of data was performed with the use of SPSS 19 .0 software . RESULTS The VAS score of the group A was（0 .98 ± 0 .34）points ,the group B （0 .97 ± 0 .35）points ;the inci‐dence of respiratory tract infections was 32 .56% in the group A ,13 .95% in the group B .The statistical analysis showed that there was no significant difference in the analgesic effect between the two groups and that the infection rates of the group B was significantly lower than that of the group A ,（P〈0 .05） .Totally 20 strains of pathogens have been isolated ,of which 25 .00% （5 strains） were Candida albicans .CONCLUSION As compared the single general anesthesia and postoperative controlled intravenous analgesia ,the epidural general anesthesia and postop‐erative controlled epidural analgesia can reduce the incidence of postoperative respiratory tract infections in the gas‐tric cancer patients ,and it is worthy to be promoted in the hospital .