王伟吉林省长春市传染（结核）病院麻醉科，吉林长春 130123

重症肺结核病手术患者麻醉处理

王伟
吉林省长春市传染（结核）病院麻醉科，吉林长春 130123

目的对重症肺结核手术患者的麻醉处理措施和效果进行分析研究。方法选取于2012年5月—2016年4月期间在该院接受手术治疗的重症肺结核患者84例，根据患者的实际病情以及手术种类的不同而选取针对性的麻醉方式，63例接受连续硬膜外+强化麻醉，21例接受静脉吸入全身麻醉。对比两组患者的心率、血压变化情况，以及并发症发生情况。结果连续硬膜外+强化麻醉组患者的心率变化为（20.18±1.88）mmHg，血压变化为（30.25± 2.56）mmHg。全身麻醉组患者的心率变化为（19.85±1.64）mmHg，血压变化为（31.05±2.21）mmHg。两组患者的心率、血压变化差异无统计学意义（P＞0.05）。连续硬膜外+强化麻醉组患者的并发症发生率为19.05%，全身麻醉患者的并发症发生率为14.29%，两组对比，差异有统计学意义（P＜0.05）。结论根据重症肺结核患者的实际病情以及手术种类的不同选择合适的麻醉方式至关重要，能够保证手术的顺利进行以及促进患者术后恢复。

重症肺结核；手术；麻醉

［Abstract］Objective Narcotic action and effects of surgical patients with severe pulmonary tuberculosis were analyzed. Methods In May 2012—2016 during April in the hospital for 84 patients with severe surgical treatment of tuberculosis，according to the actual conditions and different types of surgical patients and anesthesia to select targeted 63 patients received continuous hard+enhanced outer membrane anesthesia and 21 patients received intravenous inhalation anesthesia.Compared two groups of patients with heart rate，blood pressure changes，and complications were observed.Results Enhanced continuous epidural anesthesia patients heart rate was（20.18±1.88）mmHg，blood pressure was（30.25± 2.56）mmHg.Heart rate variability in patients with general anesthesia group was（19.85±1.64）mmHg，blood pressure was（31.05±2.21）mmHg.Heart rate，blood pressure differences between the two groups were small，not statistically significant（P＞0.05）.Enhanced continuous epidural anesthesia patients complication rate was 19.05%，in patients with general anesthesia complication rate was 14.29%，comparing the two groups，the difference was significant，statistically significant（P＜0.05）.Conclusion Depending on the actual condition of severe pulmonary tuberculosis patient selection and appropriate type of surgery anesthesia is essential，to ensure smooth operation and to promote postoperative recovery.

［Key words］Severe pulmonary tuberculosis；Surgery；Anesthesia

结核病是这种临床上较为常见的慢性传染病主要是由于结核分枝杆菌引起的，能够侵及多种脏器，最为常见的为肺部结核感染，以纳差、消瘦、盗汗、低热（午后为著）、乏力、胸痛、咳痰、咳嗽、咯血、胸闷或呼吸困难等为主要的临床症状，对于病情严重的患者临床上一般采取手术治疗［1］。该文回顾性分析2012年5月—2016年4月期间接受手术治疗的84例重症肺结核患者的临床资料和麻醉资料，现报道如下。……