儿童气道异物取出术围术期发生呼吸系统严重并发症的危险因素分析

发布时间：2018-07-05 15:17

本文选题：异物 + 并发症　；参考：《临床儿科杂志》2015年01期

【摘要】：目的探讨儿童气道异物取出术围术期发生呼吸系统严重并发症的相关危险因素。方法入选263例行硬质支气管镜气道异物取出术患儿,根据术中及术后24 h内是否发生呼吸系统严重并发症分为并发症组和非并发症组,并通过比较两组患儿既往史、术前呼吸道感染率、异物存留时间、异物种类、手术时间、麻醉效果等差异,分析儿童气道异物取出术围术期发生呼吸系统严重并发症的独立危险因素。结果入选263例患儿中31例发生呼吸系统严重并发症,发生率为11.8%。单因素分析提示,与未发生并发症的患儿比较,发生呼吸系统严重并发症患儿的术前呼吸道感染率更高,异物存留时间更长,手术时间更长,麻醉效果不佳发生率更高,差异均有统计学意义(P均0.05)。多因素logistic回归分析显示:麻醉效果不佳(OR=11.07,95%CI:3.16~38.75)、术前有呼吸道感染(OR=2.99,95%CI:1.04~8.59)、手术时间越长(OR=1.07,95%CI:1.00~1.14)是儿童气道异物取出术围手术期发生呼吸系统严重并发症的独立危险因素(P均0.05)。结论对于麻醉效果不佳、术前合并呼吸道感染、手术时间长的患儿,需警惕气道异物取出术围手术期发生呼吸系统严重并发症,并采取相应预防措施。
[Abstract]:Objective to investigate the risk factors of severe respiratory complications in children undergoing airway foreign body removal. Methods 263 children undergoing rigid bronchoscopic airway foreign body removal were divided into two groups according to whether severe respiratory complications occurred during the operation and 24 hours after operation. The history of the two groups was compared by comparing the previous history of the two groups. The respiratory tract infection rate, the retention time of foreign body, the type of foreign body, the time of operation, the effect of anesthesia and so on were analyzed. The risk factors of severe respiratory complications in children during the perioperative period of airway foreign body removal were analyzed. Results among 263 children, 31 had severe complications of respiratory system, the incidence was 11.8. Univariate analysis showed that the respiratory tract infection rate was higher, the foreign body retention time was longer, the operative time was longer, and the incidence of poor anesthesia was higher in children with severe respiratory complications than those without complications. The difference was statistically significant (P 0.05). Multivariate logistic regression analysis showed that poor anaesthesia effect (OR 11.07 ~ 95CI: 3.16: 38.75), respiratory tract infection (OR 2.9% 95 CI: 1.04% 8.59) and longer operation time (OR1.0795 CI 1.00: 1.14) were independent risk factors for severe respiratory complications in children undergoing airway foreign body removal (all P < 0. 05). Conclusion for the children with poor anesthesia, preoperative respiratory tract infection and long operation time, severe respiratory complications should be observed during the perioperative period of airway foreign body removal, and corresponding preventive measures should be taken.
【作者单位】：重庆医科大学附属儿童医院麻醉科
【基金】：国家临床重点专科建设项目(国卫办医涵[2013]544)
【分类号】：R726.1

【共引文献】