婴幼儿全身麻醉苏醒期呼吸系统不良事件的相关因素分析

摘要

目的:分析3岁以下小儿行全身麻醉后苏醒期呼吸系统不良事件的相关因素,以期为临床麻醉安全提供指导.方法:收集遵义医学院附属医院择期手术患儿80例,对于可能造成呼吸系统不良事件的相关因素进行定义,包括:年龄、性别、手术季节、手术部位、麻醉方式、是否合并上呼吸道感染病史(upper respiratory Infection,URI)、是否腹腔镜手术.不良事件包括:咳嗽、多痰、声音嘶哑、SpO2<90%、喉痉挛、支气管痉挛.监测并记录基础生命体征以及麻醉苏醒期不良事件的发生情况.结果:术前合并URI的患儿较术前未合并URI的患儿呼吸系统不良事件的发生率高,差异有统计学意义(46.2% vs 16.4%,P=0.043).术前合并URI的患儿,发生两种及以上呼吸系统不良事件的风险增加OR=9.844,95% CI=2.182 ~44.408.结论:术前合并URI会增加婴幼儿全身麻醉苏醒期呼吸系统不良事件的发生率,而年龄、性别、手术季节、手术部位、麻醉方式、是否腹腔镜手术并不是其独立影响因素.%Objective:To provide guidance for clinical anesthesia safety byanalyzing of factors related to infants respiratory sys-tem adverse events during the anesthesia recovery period.Methods:80 cases of infants who undergoing general anesthesia elective sur-gery were collected.It was defined that may cause the related influencing factors for respiratory system adverse events,including age, gender,surgery season,operative site,anesthesia method,whether combined with upper respiratory infection(URI) and Whether under-going laparoscopic surgery. Adverse events were included cough,phlegm,hoarseness,SpO2<90%,laryngismus and bronchospasm.The basic vital signs and respiratory system adverse events happened in the general anesthesia recovery period were recorded.Results:The incidence of respiratory system adverse events in the group with preoperative URI was higher than that in the group with no preoperative URI(46.2% vs.16.4%,P=0.043).The risk of happening two or more respiratory adverse events increased in infants combined with preoperative URI (OR=9.844,95% CI=2.182~44.408).Conclusions:Preoperative URI in infants will increase the incidence of respiratory system adverse events during general anesthesia recovery period.Whereas all the age,gender,surgery season,operative site, anesthesia method and whether undergoing laparoscopic surgery are not independence influence factors.