摘要
目的分析多模式镇痛对肺癌患者术后肺部感染及肺功能的影响,为医院感染的预防和控制工作提供客观依据。方法选取2017年1月-2018年1月行手术治疗的80例早期肺癌患者作为研究对象,将其分为研究组和对照组。对照组患者给予术后硬膜外自控镇痛,研究组患者给予超前镇痛联合术后硬膜外自控镇痛。观察两组患者术后肺部感染情况,应用视觉模拟评分法(VAS)对两组患者术后24h、48h、72h进行评分,比较两组患者术前和术后72h最大通气量(MVV)、用力呼气第1秒量(FEV_1)、用力肺活量(FVC)等肺功能指标。对两组患者术后不良反应进行观察和比较。结果对照组和研究组中分别有13例和3例患者于术后发生肺部感染,感染率分别为32.5%和7.5%,差异有统计学意义(P<0.05);术后48h和72h,研究组患者VAS评分均低于对照组(P<0.05);术后72h,研究组患者肺功能指标均优于对照组(P<0.05)。两组患者术后均出现恶心呕吐、头晕、嗜睡等不良反应。结论在肺癌手术中应用超前镇痛联合术后硬膜外自控镇痛的多模式镇痛方式,能够降低患者术后肺部感染率,有效缓解术后疼痛和手术对肺功能的损害,降低术后并发症的发生率。
OBJECTIVE To explore the influence of multimodal analgesia on postoperative pulmonary infection and lung function of the lung cancer patients so as to provide guidance for prevention and control of nosocomial infection.METHODS A total of 80 patients with early stage of lung cancer who received surgical procedures from Jan2017 to Jan 2018 were recruited as the study objects and divided into the study group and the control group.The control group was given patient-controlled epidural analgesia after the surgery,while the study group was treated with preemptive analgesia combined with postoperative patient-controlled epidural analgesia.The prevalence of postoperative pulmonary infection was observed,the visual analogue scale(VAS)scores were recorded at 24 h,48 hand 72 hafter the surgery,the lung function indexes such as maximum ventilation volume(MVV),forced expiratory volume in 1 st second(FEV1)and forced vital capacity(FVC)were compared between the two groups of patients before the surgery and after the surgery for 72 hours,and the postoperative adverse reactions were observed and compared between the two groups of patients.RESULTS Totally 13 patients had postoperative pulmonary infection in the control group,3 patients in the study group;the infection rates were 32.5%and 7.5%,respectively,and there was significant difference(P<0.05).The VAS scores of the study group were significantly lower than those of the control group after the surgery for 48 and 72 hours(P<0.05).The lung function indexes of the study group were significantly better than those of the control group(P<0.05).Both groups of patients had adverse reactions such as nausea and vomiting,dizziness and lethargy after the surgery.CONCLUSION The preemptive analgesia combined with patient-controlled epidural analgesia may reduce the incidence of postoperative pulmonary infection in the lung cancer patients,effectively alleviate the damage of lung function due to postoperative pain and surgery and reduce the incidence of postoperative complications.
作者
许丽琴
严虹
陈佛
陈锐
张静
李璇
XU Li-qin;YAN Hong;CHEN Fo;CHEN Rui;ZHANG Jing;LI Xuan(Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan,Hubei 430014,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第9期1384-1387,共4页
Chinese Journal of Nosocomiology
基金
武汉市卫生和计划生育委员会科研基金资助项目(WX16D36)
关键词
多模式镇痛
肺癌
手术
肺部感染
肺功能
Multimodal analgesia
Lung cancer
Surgery
Pulmonary infection
Lung function
作者简介
通信作者:严虹,E-mail:jiangyaocen386@163.com
