六岁以下患儿气管插管全身麻醉后呼吸系统不良事件的相关因素分析

发布时间：2018-04-24 15:01

本文选题：患儿 + 全身麻醉　；参考：《临床麻醉学杂志》2015年03期

【摘要】：目的分析6岁以下患儿行气管插管全身麻醉后呼吸系统不良事件的相关影响因素。方法收集普、胸、泌、骨及矫形外科患儿267例,对术前评估中所有可能造成麻醉后呼吸系统不良事件的因素进行定义和记录,包括:性别、年龄6岁、体重、术前住院日、手术实施季节、术前是否合并轻、中度上呼吸道感染症状、手术操作部位是否对呼吸具有潜在影响及麻醉维持时间。不良事件包括:咳嗽多痰、SpO2静息状态下95%、腋窝T38℃、舌后坠、气管导管移位、屏气、喉痉挛、支气管痉挛。对影响不良事件的相关因素进行二元逻辑回归分析OR值。结果年龄1岁的患儿,1种呼吸系统不良事件的发生率增加(OR=2.66,95%CI:1.50~4.71),2种及以上呼吸系统不良事件的发生率增加(OR=2.44,95%CI:1.29~4.60);术前合并上感症状的患儿,1种呼吸系统不良事件的发生率增加(OR=2.81,95%CI:1.47~5.39),2种及以上呼吸系统不良事件的发生率增加(OR=2.57,95%CI:1.31~5.03),而其余因素对发生呼吸系统不良事件的影响无统计学意义。结论年龄1岁及术前合并上感仍是发生麻醉后呼吸系统不良事件的独立危险因素;性别、体重、术前住院日、季节、手术部位及麻醉维持时间等独立因素并不增加不良事件的发生。
[Abstract]:Objective to analyze the related factors affecting the adverse events of respiratory system after general anesthesia for tracheal intubation in children under 6 years of age. Methods 267 cases of children in general, chest, secreting, bone and orthopedic surgery were collected, and all the factors that could cause adverse events of respiratory system after anesthesia were determined and recorded, including sex, age 6 years, weight, pre operation. Days of hospitalization, operation season, mild before operation, symptoms of moderate upper respiratory tract infection, potential impact of operation on breathing and duration of anesthesia. Adverse events include cough with sputum, 95% in resting state at SpO2, T38 in axilla, tongue fall, catheter displacement, breath holding, larynspasm, bronchospasm. The correlation factors of good events were analyzed by two yuan logic regression analysis (OR). Results the incidence of 1 respiratory system adverse events increased (OR=2.66,95%CI:1.50~4.71), 2 and more adverse events of respiratory system increased (OR=2.44,95%CI:1.29~4.60) in children aged 1 years of age (OR=2.44,95%CI:1.29~4.60); children with preoperative symptoms and 1 kinds of respiratory system adverse events were found. The incidence of the 2 or more adverse events of the respiratory system increased (OR=2.57,95%CI:1.31~5.03), and the other factors had no statistical significance to the adverse events of the respiratory system. Conclusion the age of 1 years and the preoperative combined feeling were still independent of the adverse events of the respiratory system after anesthesia. Factors such as risk factors, gender, weight, preoperative hospitalization days, seasons, operative sites and duration of anesthesia maintenance did not increase the incidence of adverse events.

【作者单位】：遵义医学院附属医院麻醉科;
【基金】：贵州省社会发展科技攻关项目(黔科合SY字3064号)
【分类号】：R726.1

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