不同麻醉及镇痛方法对胃癌患者术后下呼吸道感染的影响研究.pdf

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1、中华医院感染学杂志2012年第22卷第23期ChinJNosocomiolVo1．22No．232012·5275·论著不同麻醉及镇痛方法对胃癌患者术后下呼吸道感染的影响研究顾沙(浙江萧山医院麻醉科，浙江杭州311202)摘要：目的探讨不同麻醉及镇痛方法对胃癌患者术后下呼吸道感染的影响，以降低其下呼吸道感染的发生率。方法将94例行胃癌根治术的患者随机分为A组和B组，每组各47例；A组给予单纯全身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)。结果A、B组的VAS评分比较，差异无统计学意义；胃癌根治术后，

2、两组各血气指标均显著下降(P<0．05)，而B组在pH值、PaO及SpO明显高于A组，差异有统计学意义(P<0．05)；A组和B组胃癌根治术后下呼吸感染率分别为29．79和12．77，差异有统计学意义(P

3、hanalgesiaonlowerrespiratorytractinfectionsaftergastriccancersu’rgery：comparativestudyGuSha(XiaoshanHospitalofZhejiangProvince，Hangzhou，Zhejiang311202，China)Abstract：OBJfECTIVEToexploretheclinicalinfluenceofdifferentmethodsofanesthesiacombinedwithanalgesiaonthelowerrespiratoryt

4、ractinfectionaftergastriccancersurgerySOastoreducetheincidenceoftherouserrespiratorytractinfectons．METHODSAtotalof94patientsundergoinggastriccancersurgerywererandomlydividedintothegroupAandgroupBwith47casesineach．ThegroupAwasgivensimpleanesthesiaandpatient—controlledintravenous

5、analgesia(PCIA)，whilethegroupBwasgivenepiduralanesthesiacombinedwithgeneralanesthesia，andpatientcontrolledepiduralanalgesia(PCEA)．RESULTSTherewasnostatisticallysignificantdifferenceintheVASscoresbetweenthegroupAandthegroupB．Thebloodgasindexofthetwogroupsdeclinedsignificantlyaft

6、ertheresectionofgastriccarcinoma(P<0．05)，andthelevelofpHvalue，PaO2andSpO2inthegroupBwassignificantlyhigherthanthuseinthegroupA，thedifferenceswerestatisticallysignificant(P

7、eresectionofgastriccarcinoma，thedifferencewasstatisticallysignificant(P<0．05)．CONCLUSIONEpiduralanesthesiacombinedwithgeneralanesthesiaandPCEAaftergastriccarcinomasurgerycaneffectivelyreducetheincidenceofthelowerrespiratorytractinfections．Keywords：Gastriccancer；Generalanesthesi

8、a；Epiduralanesthesiacombinedwithgeneralanalgesia；Lower