全身麻醉后再次气管插管的危险因素及预后分析

发布时间：2018-03-18 07:28

本文选题：全身麻醉　切入点：恢复室　出处：《中国医学科学院学报》2017年01期 　论文类型：期刊论文

【摘要】：目的分析全身麻醉后患者在恢复室发生再次气管插管的危险因素及预后。方法回顾性分析2013年10月至2014年10月在中日友好医院接受全身麻醉的14 407例患者的临床资料,根据在恢复室是否发生再次气管插管将患者分为再次插管组和对照组,对组间差异有统计学意义的因素进行多因素Logistic回归分析,寻找再次气管插管的危险因素,并分析其预后。结果 14 407例患者中,有16例发生再次气管插管。多因素Logistic回归分析结果显示,术前合并慢性阻塞性肺疾病(COPD)(OR=17.55,95%CI:3.08~59.84,P=0.001)及冠心病(OR=5.98,95%CI:1.67~21.42,P=0.006)、术中出血量大于12 ml·kg-1(OR=27.83,95%CI:10.75~54.62,P0.001)和胸内手术(OR=22.96,95%CI:12.66~48.19,P=0.004)是再次气管插管的危险因素。结论术前合并COPD及冠心病、术中出血量大于12 ml·kg-1和胸内手术是全身麻醉后发生再次气管插管的危险因素,且大部分患者预后良好。
[Abstract]:Objective to analyze the risk factors and prognosis of re-intubation in recovery chamber after general anesthesia. Methods the clinical data of 14 407 patients undergoing general anesthesia in Sino-Japanese Friendship Hospital from October 2013 to October 2014 were analyzed retrospectively. Patients were divided into re-intubation group and control group according to whether re-intubation occurred in the recovery room. Multivariate Logistic regression analysis was carried out to find the risk factors for re-intubation. Results among 14 407 patients, 16 cases had re-intubation. Multivariate Logistic regression analysis showed that, The risk factors for re-intubation of COPD and coronary artery disease are preoperative bleeding volume greater than 12 ml 路kg-1OR 27.839 95% or 54.62% (P 0.001) and intrathoracic operation OR22.969 95 CI 12.66% 12.666.Conclusion preoperative COPD and coronary heart disease are the risk factors for re-intubation of COPD and coronary heart disease (P 0.001), and the risk factors of re-intubation are as follows: before operation, the volume of blood loss is greater than 12 ml 路kg-1OR 27.8395CI10.75% 54.62% P0.001) and the intrathoracic operation OR22.969 95 CI: 12.66% 12.66% 12.66% 48.19% P 0.004. Conclusion there is a risk factor for re-intubation of COPD and coronary heart disease before operation. Intraoperative bleeding more than 12ml 路kg-1 and intrathoracic surgery were risk factors for re-intubation after general anesthesia, and most patients had a good prognosis.
【作者单位】：中日友好医院麻醉科;
【分类号】：R614.2

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