乌司他丁对骨科手术全身麻醉患者肺部感染及血清炎症因子的影响

Effect of ulinastatin on pulmonary infection and serum inflammatory factors in general anesthesia for orthopedic surgery

目的:探究乌司他丁对骨科手术全身麻醉患者肺部感染与血清炎症因子的影响。方法:选取某院收治的60例骨科手术全身麻醉患者,按照随机数表法将患者分为2组,对照组接受常规麻醉,观察组接受乌司他丁辅助麻醉,比较2组患者肺部感染发生率、麻醉起效时间、术后苏醒时间、血清炎症因子水平,统计病原菌分布及构成比。结果:2组患者麻醉起效时间、苏醒时间比较差异有统计学意义(P<0.05);观察组患者白介素-6、白介素-8以及肿瘤坏死因子-α水平低于对照组患者,白介素-10水平高于对照组患者,差异有统计学意义(P<0.05);观察组患者肺部感染发生率低于对照组,差异具有统计学意义(P<0.05);对发生肺部感染患者进行病原菌检测,共检测出病原菌19株,包括革兰阴性菌10株(52.63%),革兰阳性菌7株(36.84%),真菌2株(10.53%),革兰阴性菌以肺炎克雷伯菌和铜绿假单胞菌为主,革兰阳性菌以表皮葡萄球菌和金黄色葡萄球菌为主。结论:乌司他丁应用于骨科手术全身麻醉患者,能有效提高麻醉药药效,缩短患者术后苏醒时间,减少肺部感染发病率,改善患者的血清炎症因子水平,值得临床推广。

Objective:To explore the effect of ulinastatin on pulmonary infection and serum inflammatory factors in general anesthesia for orthopedic surgery so as to provide prognostic results in general anesthesia for orthopedic surgery.Methods:60 patients with general anesthesia for orthopedic surgery treated in a hospital were selected and randomly divided into two groups.30 patients in the control group were given conventional anesthesia,and another 30 patients in the observation group underwent ulinastatin-assisted anesthesia.The incidence of pulmonary infection,time of onset of anesthesia,postoperative recovery time,and serum inflammatory factor levels(interleukin-6,interleukin-8,interleukin-10,tumor necrosis factor alpha)were compared between the two groups.The pathogens were detected and identified in the infected patients,and the types of pathogenic bacteria were analyzed.Results:The difference was statistically significant between the two groups in terms of onset time of anesthesia and postoperative recovery time(P<0.05).The levels of IL-6,IL-8 and TNF-αin the observation group were lower than those of the control group and IL-10 level was higher than that of the control group(P<0.05).The incidence of pulmonary infection was lower in the observation group than that in the control group(P<0.05).After detection of pathogens in patients with pulmonary infection,a total of 19 strains of pathogens were detected,including 10 Gram-negative bacteria(52.63%),7 Gram-positive bacteria(36.84%),and 2 fungi(10.53%).Gram-negative bacteria were mainly Klebsiella pneumoniae and Pseudomonas aeruginosa,and Gram-positive bacteria were mainly Staphylococcus epidermidis and gold staphylococcus aureus.Conclusion:Using of ulinastatin in patients with general anesthesia for orthopedic surgery can effectively improve the efficacy of anesthetics,shorten the recovery time of patients,reduce the incidence of lung infection,and raise the serum inflammatory factor levels.It is worthy of clinical promotion.