摘要
目的探究多模式镇痛对老年肺癌患者术后肺部感染及肺功能的影响.方法选取2019年1月—2022年1月于本院行手术治疗的106例老年肺癌患者为研究对象,采用随机数字表法分为对照组及研究组,每组53例.对照组采用常规镇痛,研究组采用多模式镇痛.比较两组患者的疼痛程度、肺功能水平、血清炎症因子水平、免疫功能及术后肺部感染发生率.结果术后24、72 h,研究组的疼痛视觉模拟评分分别为(3.41±0.38)分、(1.27±0.25)分,均低于对照组的(4.38±0.51)分、(2.14±0.33)分,组间差异有统计学意义(P<0.05).术后3、7 d,研究组的最大自主通气量、第1秒用力呼气容积、用力肺活量均大于对照组,组间差异有统计学意义(P<0.05).术后3、7 d,研究组的肿瘤坏死因子-α、C反应蛋白水平均低于对照组,白细胞介素-2、白细胞介素-10水平均高于对照组,组间差异有统计学意义(P<0.05).术后1、2周,研究组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,组间差异有统计学意义(P<0.05).研究组的肺部感染发生率为3.77%,低于对照组的9.43%,差异有统计学意义(P<0.05).结论老年肺癌患者采用多模式镇痛的效果理想,能有效减轻术后疼痛,降低炎症因子水平,缓解机体免疫损伤,减少术后肺部感染的发生,有利于其肺功能恢复,值得临床推广使用.
Objective To explore the effect of multimodal analgesia on postoperative pulmonary infection and pulmonary function in elderly patients with lung cancer.Methods 106 elderly patients with lung cancer who underwent surgical treatment in the hospital from January 2019 to January 2022 were selected as the study objects and were divided into a control group and a study group by digital random table method,with 53 cases in each group.The control group was treated with conventional analgesia,while the study group was treated with multimodal analgesia.The pain degree,pulmonary function levels,serum inflammatory factors,immune function and the incidence of postoperative pulmonary infection were compared between the two groups.Results 24 and 72 hours after operation,the visual analogue scale scores of the study group were(3.41±0.38)points and(1.27±0.25)points,respectively,which were lower than(4.38±0.51)points and(2.14±0.33)points of the control group,and the differences between the groups were statistically significant(P<0.05).3 and 7 days after operation,the maximum voluntary ventilation volume,forced expiratory volume at the first second and forced vital capacity of the study group were greater than those of the control group,and the differences between the groups were statistically significant(P<0.05).3 and 7 days after operation,the levels of tumor necrosis factor-αand C-reactive protein in the study group were lower than those in the control group,and the levels of interleukin-2 and interleukin-10 were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).1 and 2 weeks after operation,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the study group were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of postoperative pulmonary infection in the study group was 3.77%,lower than 9.43%in the control group,and the difference was statistically significant(P<0.05).Conclusion The effect of multimodal analgesia in elderly patients with lung cancer is ideal,which can effectively reduce postoperative pain and the level of inflammatory factors,alleviate immune damage,and reduce the occurrence of postoperative pulmonary infection,which is conducive to the recovery of pulmonary function,and is worthy of clinical promotion.
作者
周小平
马雪萍
喇宏玲
ZHOU Xiaoping;MA Xueping;LA Hongling(Department of Anesthesiology,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi Xinjiang,830001,China)
出处
《反射疗法与康复医学》
2023年第8期119-122,159,共5页
Reflexology And Rehabilitation Medicine
基金
新疆维吾尔自治区人民医院院内项目(20200312)。
关键词
老年肺癌患者
多模式镇痛
术后疼痛
肺部感染
肺功能
炎症因子
免疫功能
Elderly patients with lung cancer
Multimodal analgesia
Postoperative pain
Pulmonary infection
Pulmonary function
Inflammatory factors
Immune function
作者简介
周小平(1987-),男,四川南充人,本科,主治医师,研究方向:老年患者器官保护;通信作者:喇宏玲(1988-),女,河北张家口人,硕士研究生,主治医师,研究方向:老年患者器官保护,邮箱:yikelahongling@sina.cn。
