小儿气道异物取出术围术期并发症的危险因素分析

发布时间：2018-06-12 19:53

本文选题：呼吸 + 异物　；参考：《上海医学》2014年04期

【摘要】：目的分析小儿气道异物取出术围术期并发症发生的危险因素。方法回顾性分析复旦大学附属眼耳鼻喉科医院自2012年3月—2013年3月在全身麻醉下行气道异物取出术的7岁以下患儿的临床资料,根据围术期是否发生并发症分入并发症组和无并发症组。比较两组患儿性别、年龄、体重、异物类型、异物存留时间、症状、术前影像学表现、异物位置、手术时间和麻醉方式等的情况,采用多因素Logistic回归分析临床各项因素与围术期并发症的关系。结果共280例患儿于全身麻醉下行气道异物取出术,围术期并发症发生率为11.1%(31/280)。并发症组31例,无并发症组249例。两组间患者的性别构成、年龄、体重、异物存留时间、手术时间的差异均无统计学意义(P值均0.05)。有2项和2项术前症状的患者围术期并发症发生率分别为18.3%(23/126)和13.8%(4/29),均显著高于有1项术前症状者的3.2%(4/125,P值均0.05);有1项和≥2项术前肺部影像学表现的患者围术期并发症发生率分别为10.0%(12/120)和16.8%(18/107),均显著高于无术前肺部影像学表现者的1.9%(1/53,P值均0.05);麻醉通气方式中,保留自主呼吸的患者的围术期并发症发生率为25.0%(11/44),显著高于经ManujetⅢ手动控制喷射通气者的7.0%(14/199)和经硬支气管镜侧孔手动控制通气者的16.2%(6/37,P值均0.05)。多因素Logistic回归分析显示,围术期并发症的发生与术前肺部影像学表现(OR=2.045,95%CI为1.129~3.706)和麻醉通气方式(OR=1.964,95%CI为1.263~3.054)有关(P值均0.05)。结论术前影像学表现异常和自主呼吸通气方式是小儿气道异物取出术围术期发生并发症的危险因素。
[Abstract]:Objective to analyze the risk factors of perioperative complications in children's airway foreign body removal. Methods the clinical data of children under 7 years old in Otolaryngological Hospital Affiliated to Fudan University from March 2012 to March 2013 under general anesthesia were analyzed, and the complications were divided into complications group according to the complications during the perioperative period. The sex, age, weight, body weight, foreign body type, foreign body retention time, symptoms, preoperative imaging, foreign body position, operation time and mode of anesthesia were compared between the two groups. The relationship between the clinical factors and perioperative complications was analyzed by multiple factor Logistic regression. The results of 280 children were under general anesthesia. The incidence of perioperative complications was 11.1% (31/280). There were 31 cases in complication group and 249 cases without complication. There was no significant difference in sex composition, age, weight, foreign body retention time, and operation time (P value 0.05). 2 and 2 preoperative symptoms were 18, respectively, and the incidence of complications was 18, respectively. .3% (23/126) and 13.8% (4/29) were significantly higher than 3.2% (4/125, P, 0.05) with 1 preoperative symptoms, 1 and 2 preoperative pulmonary imaging findings were 10% (12/120) and 16.8% (18/107), respectively, which were significantly higher than 1.9% (1/53, P, 0.05) without preoperative pulmonary imaging. The incidence of perioperative complications in patients with spontaneous breathing was 25% (11/44), significantly higher than 16.2% (6/37, P, 0.05) of 7% (14/199) and manual controlled ventilation by Manujet III manual control. Multiple factor Logistic regression analysis showed that perioperative complications were associated with pre operation lung. The imaging findings (OR=2.045,95%CI 1.129~3.706) and anesthesia ventilation (OR=1.964,95%CI 1.263~3.054) were related (P value was 0.05). Conclusion the preoperative imaging abnormalities and autonomous respiratory ventilation were the risk factors for the perioperative complications in children's airway foreign body removal.
【作者单位】：复旦大学附属眼耳鼻喉科医院麻醉科;
【分类号】：R768.4

【参考文献】