不同麻醉方式对感染性休克患者处理效果分析

Effects of different anesthesia methods on treatment of patients with septic shock

目的分析不同麻醉方法对感染性休克患者的处理效果,总结麻醉经验,为临床麻醉方式选择提供依据。方法选取2012年7月-2015年7月医院收治的感染性休克患者60例,根据麻醉方式分为复合麻醉组与全身麻醉组,每组各30例,复合麻醉组采取气管插管复合全身麻醉,全身麻醉组则实施全身麻醉,观察两组患者手术前后平均动脉压(MAP)、血氧饱和度(SpO2)、收缩压(SBP)、舒张压(DBP)、呼吸频率(R)、心率(HR)、不良反应发生率。结果两组患者手术前各项指标差异无统计学意义;手术后两组患者各项指标均较术前有所改善,复合麻醉组改善更加明显(P<0.05);复合麻醉组患者发生高血压1例、心动过速及恶心呕吐各2例,发生率为16.67%,全身麻醉组患者发生高血压1例、心动过速3例、恶心呕吐2例,发生率为20.00%,两组不良反应发生率无统计学意义。结论感染性休克患者采用气管插管复合全身麻醉可以有效改善各项循环、呼吸指标,维持内环境的稳定,提高手术安全性,临床值得推广。

OBJECTIVE To observe the effect of different anesthesia methods on treatment of patients with septic shock and summarize the experience of anesthesia so as to provide guidance for clinical anesthesia.METHODS A total of 60 patients with septic shock who were treated in the hospital from Jul 2012 to Jul 2015 were enrolled in the study and divided into the compound anesthesia group and the general anesthesia group according to the anesthesia,with 30 cases in each.The compound anesthesia group was treated with endotracheal intubation combined with general anesthesia,while the general anesthesia group was treated with the general anesthesia.The mean arterial pressure（MAP）,blood oxygen saturation（SpO2）,systolic pressure（SBP）,diastolic blood pressure（DBP）,respiratory rate（R）,heart rate（HR）,and incidence of adverse reactions were observed and compared between the two groups of patients before and after the surgery.RESULTS There was no significant difference in the indicators between the two groups of patients before the surgery.The indicators of the two groups of patients were improved after the surgery,and they were improved more significantly in the compound anesthesia group than in the general anesthesia group（P0.05）.There were 1case of hypertension,2cases of tachycardia,and 2cases of nausea and vomiting,with the incidence rate 16.67%;there were 1case of hypertension,3cases of tachycardia,and 2cases of nausea and vomiting,with the incidence rate 20.00%,and there was no significant difference in the incidence of adverse reactions between the two groups.CONCLUSION The endotracheal intubation combined with general anesthesia can effectively improve the circulation,breathing indicators,maintain homeostasis,and raise the surgical safety of the patients with septic shock,and it is worthy to be promoted in the hospital.