作　　者： ; ;

机构地区： 廉江市人民医院

出　　处： 《中国当代医药》 2019年第23期133-136,共4页

摘　　要： 目的探讨全身麻醉联合椎管内阻滞麻醉在老年慢性阻塞性肺疾病(COPD)患者手术中的应用效果。方法选取2015年3月~2018年6月我院收治的100例老年COPD患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组各50例。对照组患者给予椎管内阻滞麻醉,观察组患者给予全身麻醉联合椎管内阻滞麻醉。比较两组患者的麻醉效果、不同时间点气道峰值、炎症因子[白介素-8(IL-8)、白介素(IL-6)、血清肿瘤坏死因子-α(TNF-α)]、尿素氮及血肌酐水平。结果观察组的总有效率为98%,高于对照组的88%,差异有统计学意义(P<0.05)。观察组患者建立气腹30、60min后及术后的尿素氮和血肌酐水平均低于对照组,差异有统计学意义(P<0.05)。观察组患者术中及术后的IL-8、IL-6及TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。观察组患者插管后、气腹后30min以及气腹解除后的气道峰值均低于对照组,差异有统计学意义(P<0.05)。结论全身麻醉联合椎管内阻滞麻醉用于老年COPD患者手术能够显著提升麻醉效果,镇痛效果明显,有效降低了术中及术后的炎症因子、气道峰值、尿素氮及血肌酐水平,使手术进程顺利,可于临床推广。 Objective To investigate the application effect of general anesthesia combined with intraspinal block anesthesia in the operation of elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 100 elderly COPD patients admitted to our hospital from March 2015 to June 2018 were selected as the study subjects.They were divided into observation group and control group according to the random number table method,50 cases in each group.Patients in the control group were given anesthesia for intraspinal block,and patients in the observation group were given general anesthesia combined with intraspinal block anesthesia.The anesthetic effect,airway peaks,inflammatory factors(interleukin-8[IL-8],interleukin[IL-6],serum tumor necrosis factor-α[TNF-α]),urea nitrogen and serum creatinine levels at different time points of the two groups were compared.Results The total effective rate of the observation group was 98%,which was higher than that of the control group accounting for 88%,and the difference was statistically significant(P<0.05).The levels of urea nitrogen and serum creatinine in the observation group were lower than those in the control group after 30 and 60 minutes of pneumoperitoneum and after surgery,and the differences were statistically significant(P<0.05).The levels of IL-8,IL-6 and TNF-αin the observation group during and after surgery were lower than those in the control group,and the differences were statistically significant(P<0.05).The airway peaks of the observation group after intubation,30 minutes after pneumoperitoneum and airway ablation were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion General anesthesia combined with intraspinal block anesthesia for elderly patients with COPD can significantly improve the anesthetic effect,have obvious analgesic effect,and it can effectively reduce the levels of inflammatory factors,urea nitrogen,serum creatinine and airway peak value during and after surgery,which makes the

关 键 词： 临床效果 老年慢性阻塞性肺疾病 椎管内阻滞麻醉 全身麻醉

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