乌司他丁对老年胃癌根治术患者术后并发肺部感染的影响

摘要

目的：探讨老年胃癌根治术患者围手术期使用乌司他丁对术后肺部感染的影响。方法：选择40例接受胃癌根治手术的老年患者，随机分为乌司他丁组和对照组，在手术后第3~5d按照《医院内获得性支气管-肺感染诊断标准》观察发生肺部感染情况；并于手术后第4d对患者进行痰液细菌培养，并鉴定阳性细菌株类别。结果：胃癌根治术后两组患者的肺部感染发生率，乌司他丁组(10%)明显低于对照组(40%)，两组比较差异有统计学意义(P<0.05)。对10例肺部感染者行痰液细菌培养，8例阳性(阳性率80%)，乌司他丁组阳性细菌明显少于对照组。对照组有1例术后第3天发生急性呼吸衰竭，行气管插管后，送重症监护病房(ICU)呼吸机辅助治疗；1例呼吸道分泌物多，难以吸出，行气管切开。本组患者40例最终均痊愈出院，未出现死亡病例。结论：乌司他丁能够有效控制老年胃癌根治术患者术后肺部感染的发生率，并可能参与了抑制细菌生长和繁殖过程。%Objective:To discusse in elderly patients with gastric cancer radical perioperative use of ulinastatin on postoperative pulmonary infection. Method:Choose 40 cases of elderly patients with gastric cancer radical surgery,were randomly divided into ulinastatin group and the control group,in 3-5 days after the operation,in accordance with the“nosocomial acquired bronchus,lung infection diagnosis standard observation lung infection happens;And in 4 days after the surgery for patients with sputum bacterial culture,and identification of positive bacteria strains.Result:The incidence of pulmonary infection in patients with gastric cancer radical surgery two groups and ulinastatin group (10%),significantly lower than the control group (40%),are similar between the two groups have statistical significance (P<0.05). 10 cases of pulmonary infection line sputum bacterial culture,8 cases were positive (positive rate 80%),positive bacteria ulinastatin group was obviously less than control group.Control group 1 cases of postoperative acute respiratory failure,3 days after endotracheal intubation,sent to intensive care unit (ICU) breathing machine auxiliary treatment;1 case of respiratory secretions,more difficult to suck out,tracheotomy. This group of patients with 40 cases were recovered and discharged,eventually caused no deaths.Conclusion:Ulinastatin can effectively control the incidence of lung infection in elderly patients with gastric cancer radical surgery,and may be involved in the inhibition of bacterial growth and reproduction.