【摘要】：目的本文對全身麻醉與神經(jīng)阻滯麻醉對膝關(guān)節(jié)置換患者術(shù)后醫(yī)院感染的影響進行了簡要的分析,針對患者半髖關(guān)節(jié)置換手術(shù)后的影響,對全身麻醉和周圍神經(jīng)阻滯麻醉這兩種方式做了探討和其臨床的適用性。方法本文選擇了2014年2月~2017年2月醫(yī)院的120例患者做過行膝關(guān)節(jié)置換術(shù)的,將其分成了一、二兩組,每組各60例,分別選用全身麻醉的方式(一組)和周圍神經(jīng)阻滯麻醉的方式(二組);分別從麻醉起效時間、阻滯完成時間、藥物劑量及術(shù)后感覺恢復(fù)時間來記錄和觀察這兩組患者的情況,手術(shù)過后還要對患者的感染情況及感染病原菌分布及藥敏試驗結(jié)果進行觀察。結(jié)果一組無論是從麻醉起效時間、阻滯完成時間還是術(shù)后感覺恢復(fù)時間都比二組的時間短(P0.05),而二組的麻醉使用劑量相對于一組(P0.05)也是非常低的。其結(jié)果如下:一組感染率為11.2%,共分離菌株12株,革蘭陽性菌48株;二組感染率為3.5%,共分離菌株21株,革蘭陽性菌39株。結(jié)論這兩組所培養(yǎng)出的革蘭陰性菌的抗菌耐藥性特別高,有的以達到100%,像喹諾酮類、氨基糖苷類、第三代頭孢菌素等,還有一些相對敏感的藥物,像阿米卡星、美羅培南、頭孢哌酮/舒巴坦及亞胺培南等。而培養(yǎng)出的革蘭陽性菌抗菌耐藥的藥物就是克林霉素、青霉素等,敏感的藥物就是利福平、萬古霉素及替考拉寧等等。
[Abstract]:Objective to analyze the effect of general anesthesia and nerve block anesthesia on hospital infection in patients with knee arthroplasty, and to explore the clinical applicability of general anesthesia and peripheral nerve block anesthesia in view of the effect of hemicap arthroplasty. Methods 120 patients who underwent knee arthroplasty from February 2014 to February 2017 were divided into two groups, 60 cases in each group. General anesthesia (group 1) and peripheral nerve block anesthesia (group 2) were used respectively. The patients in these two groups were recorded and observed from the onset time of anesthesia, the completion time of block, the dose of drugs and the time of postoperative sensory recovery, respectively. after the operation, the infection, the distribution of pathogenic bacteria and the results of drug sensitivity test were also observed. Results both the onset time of anesthesia, the completion time of block and the time of postoperative sensory recovery in the first group were shorter than those in the second group (P 0.05), and the dose of anesthesia in the two groups was also very low compared with the first group (P 0.05). The results were as follows: the infection rate of the first group was 11.2%, 12 strains were isolated and 48 strains were Gram-positive bacteria, the infection rate of the two groups was 3.5%, 21 strains were isolated and 39 strains were Gram-positive bacteria. Conclusion the antibacterial resistance of Gram-negative bacteria cultured in these two groups is particularly high, some of which reach 100%, such as quinolones, aminoglycosides, third-generation cephalosporins, and some relatively sensitive drugs, such as amikacin, meropenem, cefoperazone / sulbactam and imipenem. The resistant drugs of Gram-positive bacteria are clindamycin, penicillin and so on, and the sensitive drugs are rifampicin, vancomycin and teicoplanin.
【作者單位】： 蘭陵縣大仲村鎮(zhèn)中心衛(wèi)生院;
【分類號】：R614

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