成人全身麻醉下鼻道手术苏醒期躁动的影响因素分析

发布时间：2018-03-13 22:30

本文选题：全身麻醉　切入点：鼻道手术　出处：《临床耳鼻咽喉头颈外科杂志》2015年21期 　论文类型：期刊论文

【摘要】：目的:分析成人全身麻醉下鼻道手术苏醒期躁动(EA)的发生率及影响因素,为临床预防和控制EA提供依据。方法:随机选取并分析2013-02-2015-02期间住院治疗并行全身麻醉下鼻道手术的674例成年患者。依据镇静-躁动评分(SAS)对患者EA进行评定,并依据是否发生躁动分为对照组(518例)和EA组(156例)。分析人口学及临床相关指标对躁动发生的影响,并进行多元Logistic回归分析。结果:全身麻醉作用下鼻道手术患者EA发生率为23.15%。与对照组相比较,EA组患者在性别、年龄、ASA分级、吸烟史、脑血管病史、术前焦虑、使用咪达唑仑、麻醉方式、术后疼痛、术后镇痛、气管导管、留置尿管、苏醒方式等方面差异有统计学意义(P0.05);多元Logistic回归结果表明,较轻的年龄、男性、术前焦虑、静吸复合麻醉、术后疼痛、气管插管及留置尿管为全身麻醉下鼻道手术患者EA发生的危险因素,年长者、配合使用咪达唑仑、全凭静脉麻醉、术后镇痛以及自然苏醒为保护性因素。结论:EA是成人全身麻醉下鼻道手术后的常见并发症,并与多种因素相关。临床应将具有以上危险因素的患者作为发生EA的高危群体重点关注,采取有效预防措施,保证患者平稳地度过苏醒期。
[Abstract]:Objective: to analyze the incidence and influencing factors of restless EAA in adult patients undergoing nasal canal operation under general anesthesia. Methods: 674 adult patients who were hospitalized during 2013-02-2015-02 and underwent general anesthesia under nasal tract operation were randomly selected and analyzed. EA was assessed according to sedation and restlessness score (SAS). According to whether restlessness occurred, 518 cases were divided into control group (518 cases) and EA group (156 cases). The effect of demographic and clinical indexes on the occurrence of restlessness was analyzed. Multivariate Logistic regression analysis was performed. Results: the incidence of EA in patients undergoing nasal surgery under general anesthesia was 23.15.Compared with the control group, patients in the EA group were treated with midazolam in terms of sex, age, smoking history, history of cerebrovascular disease, preoperative anxiety, and midazolam use. There were significant differences in anesthesia, postoperative pain, postoperative analgesia, trachea catheter, indwelling urethral catheter, recovery mode and so on. Multivariate Logistic regression analysis showed that younger age, male, preoperative anxiety, combined intravenous anesthesia, postoperative pain, and postoperative pain. Endotracheal intubation and indwelling urethral catheter were the risk factors for EA in patients undergoing nasal surgery under general anesthesia. Postoperative analgesia and spontaneous recovery were protective factors. Conclusion: the common complications of nasal tract surgery under general anesthesia in adults are: 1. The patients with the above risk factors should be regarded as the high risk groups of EA, and effective preventive measures should be taken to ensure the patients to survive smoothly.
【作者单位】：南阳市中心医院麻醉科;
【分类号】：R765.9

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