腰硬联合麻醉与全身麻醉对老年开腹手术患者的效果及术后肺部感染的影响

Effect of combined spinal-epidural anesthesia and general anesthesia on elderly patients with open surgery and its influence on postoperative lung infection

目的分析腰硬联合麻醉与全身麻醉对老年开腹手术患者的效果及术后肺部感染的影响。方法40例老年开腹手术患者,随机分为对照组及研究组,各20例。对照组患者给予全身麻醉,研究组患者给予腰硬联合麻醉。比较两组术后24 h简易智力状态检查量表(MMSE)评分、术后肺部感染发生率、麻醉起效时间、术后清醒时间。结果研究组患者术后24 h的MMSE评分(27.21±2.21)分高于对照组的(25.56±1.91)分,术后肺部感染发生率5.00%低于对照组的30.00%,差异均具有统计学意义(P<0.05)。研究组患者的麻醉起效时间(6.34±1.54)min、术后清醒时间(2.82±0.63)min均短于对照组的(9.26±1.41)、(3.41±0.82)min,差异均具有统计学意义(P<0.05)。结论相对于全身麻醉,腰硬联合麻醉在老年开腹手术中的临床应用效果确切,可有效减轻对患者认知功能的影响,缩短麻醉起效时间和术后清醒时间,降低术后肺部感染风险,值得推广和应用。

Objective To analyze the effect of combined spinal-epidural anesthesia and general anesthesia on elderly patients with open surgery and its influence on postoperative lung infection.Methods A total of 40 elderly patients with open surgery were randomly divided into control group and research group,with 20 cases in each group.The control group received general anesthesia,and the research group received combined spinal-epidural anesthesia.The mini-mental state examination(MMSE)score 24 h after operation,the incidence of postoperative pulmonary infection,the onset time of anesthesia and the awake time after operation were compared between the two groups.Results The MMSE score 24 h after operation(27.21±2.21)points of the research group was higher than(25.56±1.91)points of the control group,and incidence of postoperative pulmonary infection 5.00%was lower than 30.00%of the control group,and the difference was statistically significant(P<0.05).The onset time of anesthesia and the awake time after operation of the research group were(6.34±1.54)and(2.82±0.63)min,which were all shorter than(9.26±1.41)and(3.41±0.82)min of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with general anesthesia,combined spinal-epidural anesthesia has a definite clinical effect in elderly open surgery,which can effectively reduce the impact on patients’cognitive function,shorten the time of anesthesia effect and postoperative wakefulness,and reduce the risk of postoperative lung infection.It is worth promoting and applying.