本文選題：麻醉方式 + 下肢骨折��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年19期

【摘要】：目的研究不同麻醉方式對老年下肢骨折患者術(shù)后肺部感染的影響,以期為臨床老年下肢骨折患者選擇最佳麻醉方式提供參考。方法選取2012年1月-2015年1月間行下肢骨折手術(shù)的老年患者264例,根據(jù)術(shù)前會診、患者及家屬意愿選定的麻醉方案實(shí)施麻醉術(shù)。其中氣管插管全身麻醉74例(A組),硬膜外麻醉122例(B組),68例行腰硬聯(lián)合麻醉(C組);觀察三組患者手術(shù)一般情況及呼吸功能相關(guān)指標(biāo)及術(shù)后肺部感染的發(fā)生情況。結(jié)果三組患者在出血量、手術(shù)時間、疼痛評分與住院時間,差異無統(tǒng)計學(xué)意義。麻醉前,三組患者血氧飽和度(SpO_2)、呼吸速率(RR)、分鐘通氣量(MV)無顯著差異,手術(shù)結(jié)束后A組與B組呼吸功能相關(guān)指標(biāo)無顯著差異,但C組與A組與B組相比,差異顯著(P0.05)。A組術(shù)后肺部感染率8.11%,B組則為4.92%,C組則為2.94%。C組感染率顯著低于A組與B組(P0.05)。結(jié)論老年下肢骨折患者選擇腰硬聯(lián)合阻滯麻醉,有助于患者術(shù)后改善呼吸功能并顯著降低術(shù)后肺部感染的發(fā)生率。
[Abstract]:Objective to study the effect of different anesthetic methods on postoperative pulmonary infection in the elderly patients with lower limb fractures, in order to provide a reference for the best way to choose the best anesthesia for the elderly patients with lower limb fractures. Methods 264 elderly patients with lower limb fracture operation in January 2012 January were selected and selected according to the preoperative consultation, patients and their families' wishes. 74 cases of tracheal intubation general anesthesia (group A), 122 cases of epidural anesthesia (group B) and 68 cases of combined lumbar epidural anesthesia (group C) were performed. The general situation of operation and respiratory function related indexes and the incidence of postoperative pulmonary infection in the three groups were observed. Results the amount of bleeding, operation time, pain score and time of hospitalization were observed in the three groups. Before anesthesia, there was no significant difference in blood oxygen saturation (SpO_2), respiratory rate (RR) and minute ventilation (MV) in the three groups. There was no significant difference in the respiratory function between the A group and the B group after the operation, but the difference was significant (P0.05) in the C group and the A group (P0.05) in the postoperative lung infection rate of 8.11%, the B group 4.92%, and the C group. The infection rate of group C was significantly lower than that of group A and group B (P0.05). Conclusion the selection of combined spinal epidural anesthesia for the elderly patients with lower limb fracture can help the patients improve their respiratory function after operation and significantly reduce the incidence of postoperative pulmonary infection.

【作者單位】： 金華市文榮醫(yī)院麻醉科;
【基金】：浙江省衛(wèi)生廳基金資助項(xiàng)目(kb2812)
【分類號】：R614

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