硬膜外自控镇痛对胸部手术患者术后肺功能及炎性因子的影响观察

目的研究硬膜外自控镇痛对胸部手术患者术后肺功能及炎性因子的影响。方法选取2009年12月~2011年12月于本院进行胸部手术的68例患者为研究对象,将其随机分为对照组（静脉自控镇痛组）和观察组（硬膜外自控镇痛组）各34例,将两组患者术前及术后1、3、5 d的肺功能及炎性因子水平进行比对。结果术后1、3、5 d观察组的肺活量、呼吸频率、动脉血氧分压、呼气峰流速、潮气量与血清IL-6、IL-8、IFN-γ、hs-CRP及TNF-α水平的波动幅度均小于对照组,两组术后不同时段分别比较,差异均有统计学意义（均P〈0.05）。结论硬膜外自控镇痛对改善胸部手术患者术后肺功能及控制炎性状态均有积极的作用。

Observation on the influence of patient-controlled epidural analgesia for the pulmonary function and inflammatory factors of patients with thoracic operation after surgery

Objective To study the influence of patient-controlled epidural analgesia for the pulmonary function and inflammatory factors of patients with thoracic operation after surgery.Methods 68 patients with thoracic operation in our hospital from December 2009 to December 2011 were selected as research object,and they were randomly divided into control group(patient-controlled intravenous analgesia group) and observation group(patient-controlled epidural analgesia group) with 34 cases in each group,then the pulmonary function and serum inflammatory factors of two groups before and after the surgery at first,third and fifth day were compared.Results The fluctuation range of vital capacity,respiratory rate,arterial partial pressure of oxygen,peak expiratory flow rate,tidal volume and serum IL-6,IL-8,IFN-γ,hs-CRP,TNF-α of observation group after the surgery at first,third and fifth day were all smaller than those of control group,those of two groups at different times were compared,there were all significant differences(all P < 0.05).Conclusion The patient-controlled epidural analgesia plays an active role in improving pulmonary function and controlling the inflammation situation of patients with thoracic operation after surgery.