麻醉与镇痛方式对宫颈癌患者术后下呼吸道感染影响评价

The evaluation of the effect of anesthesia and analgesia on lower respiratory tract infection in patients with cervical cancer

目的分析麻醉与镇痛方式对宫颈癌患者术后下呼吸道感染的影响。方法选取医院收治的宫颈癌患者120例为研究对象,患者均在医院实施手术治疗。回顾性分析患者的病历资料,按照麻醉与术后镇痛方式的不同将其分为4组,每组30例。第一组采用全身麻醉和术后静脉镇痛;第二组采用全身麻醉和术后硬膜外镇痛;第三组采用硬膜外腔阻滞麻醉和术后静脉镇痛;第四组采用硬膜外腔阻滞麻醉和术后硬膜外镇痛。比较4组患者术后的疼痛程度以及下呼吸道感染的发生率。结果 4组患者下呼吸道感染的发生率依次为40.0%、26.7%、23.3%和3.3%,其中第四组下呼吸道感染的发生率最低,与其他3组数据比较差异有统计学意义(P<0.05或P<0.01);第二组和第三组患者的下呼吸道感染发生率比较差异无统计学意义(P>0.05)。第二组和第四组患者术后的VAS评分低于第一组和第三组(P<0.01);第二组和第四组患者VAS评分比较差异无统计学意义(P>0.05)。结论宫颈癌患者采用硬膜外腔阻滞麻醉和术后硬膜外镇痛方式术后下呼吸道感染的发生率最低,安全性高,且患者术后疼痛感较轻,该麻醉和镇痛方式可在宫颈癌根治术和术后治疗中进行推广应用。

Objective To analyze the effect of anesthesia and analgesia on lower respiratory tract infection in patients with cervical cancer. Methods 120 patients with cervical cancer admitted to the hospital were selected as the study subjects,and all patients were treated surgically in the hospital. Retrospective analysis of the patient＇s medical records,according to the different anesthesia and postoperative analgesia were divided into 4 groups,30 cases in each group. The first group received general anesthesia and postoperative intravenous analgesia. The second group received general anesthesia and postoperative epidural analgesia. The third group received epidural block anesthesia and postoperative intravenous analgesia. The fourth group received epidural block anesthesia and postoperative epidural analgesia. The degree of postoperative pain and the incidence of lower respiratory tract infections were compared among the 4 groups. Results The incidences of lower respiratory tract infection were 40. 0%,26. 7%,23. 3% and 3. 3% respectively in the four groups. The incidence of lower respiratory tract infection in the fourth group was the lowest,which was statistically significant compared with the other three groups（ P〈0. 05 or P〈0. 01）. There was no significant difference in the incidence of lower respiratory infection between the second and third groups（ P〉0. 05）. The VAS scores of the second and fourth groups of patients were lower than those of the first group and the third group（ P〈0. 01）,while the VAS scores of the second group and the fourth group were not significantly different（ P〉0. 05）. Conclusion The incidence of postoperative lower respiratory tract infection in patients with cervical cancer using epidural anesthesia and postoperative epidural analgesia is the lowest,with high safety and mild postoperative pain. This anesthetic and analgesic methods can be applied in the radical surgery and postoperative treatment of cervical cancer.