不同麻醉方式对老年患者上腹部手术肺部感染的影响

doi:10.3969/j.issn.1006-6233.2017.01.040

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Abstract Objective: To observe the effects of different anesthetic methods on postoperative pulmonary infections in the elderly patients with upper abdominal surgery. methods: A total of 102 cases of elderly patients with upper abdominal surgery from April 2014 to April 2016 were enrolled. They were randomly divided into epidural block combined with general anesthesia (group A), inhalation anesthesia group (group B) and total intravenous anesthesia group (group C) with 34 cases each. The extubation time, recovery time, incidence of postoperative pulmonary infections were observed and compared among the three groups. Results: The extubnation time, recovery time and incidence of postoperative pulmonary infection in group A were significantly better than those in both group B and group C (p<0.05), but there was no significant difference in those between group B and group C (p>0.05). The level of interleukin-6(IL-6) and interleukin-8(IL-8) were increased apparently in the 6h after the surgery of the three groups (p<0.05), but T lymphocyte subsets CD4+/CD8+ ratio reduced apparently (p<0.05) compared with those before anesthesia. 3d after the operation, the level of IL-6, IL-8 and CD4+/CD8+ ratio in group A restored to preoperative level while those in group B and C did not(p<0.05). Conclusion: Epidural block combined with general anesthesia has a positive effect on postoperative recovery of consciousness and reduces the incidence of (postoperative) pulmonary infection.

Key words： Anesthesia Upper abdominal surgery Lung infection Elderly patients

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2017.01.040 OR http://www.hbyxzzs.cn/EN/Y2017/V23/I1/119