摘要
目的分析儿童于冬、夏两季行气管插管全身麻醉后围术期麻醉相关不良事件的发生差异及相关影响因素。方法477例患儿依据季节自然分入冬季组及夏季组,记录患儿手术实施及预后情况,包括：手术时间、PACU复苏时间、住院时间,术后HR、Sp O2及T等基本生命体征;比较两组包括咳嗽多痰、静息状态下Sp O2〈95%、体温异常等不良事件,以及舌后坠、屏气、喉痉挛、支气管痉挛等严重不良事件的发生情况;分析可能造成不良事件的危险因素,包括：年龄、性别、ASA、麻醉时间、是否上感、手术操作是否影响呼吸及术前住院时间,并将上述因素与不良事件的关系行二元逻辑回归分析,以OR值95%可信区间（CI）评价。结果有效病例中,夏季手术274例、冬季手术203例。所有患儿手术顺利,无危及生命的恶性不良事件及死亡病例,手术实施情况及预后情况比较,两组差异无统计学意义;咳嗽多痰、Sp O2〈95%、体温〉38°等不良事件发生率冬季的40.88%、13.30%、16.25%高于夏季的31.02%、4.01%、8.02%（P〈0.05）;舌后坠、屏气、喉痉挛及支气管痉挛等严重不良事件的发生率两组比较差异无统计学差异;夏季组年龄≤1y患儿不良事件发生率是其余患儿的3.69倍（95%CI：1.84-7.38）、冬季组年龄≤1y患儿不良事件发生率是其余患儿的2.41倍（95%CI：1.08-5.39）。结论在冬季接受全身麻醉的患儿应该关注围术期不良事件的发生情况。同时,年龄≤1岁是儿童实施全身麻醉发生麻醉相关不良事件的独立危险因素,无论季节均应给予足够重视。
Objective To analyze the differences of perioperative anesthesia-related adverse events in children undergone endotracheal general anesthesia in winter and summer and the related influence factors.Methods 447 cases of children were divided into the winter group and summer group according to the seasons.The implementation of surgery and diagnosis were recorded,including surgery time,PACU awaking time,hospitalization time and basic vital signs such as postoperative HR,Sp O2 and T（temperature）,etc.;the two groups were compared for the adverse events including cough and phlegm,Sp O2 95% at resting state and abnormal temperature,etc.,and serious adverse events including glossocoma,breath holding,laryngospasm and bronchospasm,etc.;Risk factors that may cause adverse events were analyzed,including age,gender,Anesthesia risk Score,anesthesia time,the presence of upper respiratory infection（URI）,whether operation affected breathing and preoperative hospitalization time.Binary logistic regression analysis was conducted on the relationship between the above factors and adverse events,evaluated by confidence interval（CI） of 95% OR.Results Among effective cases,274 cases were given surgery in summer while 203 cases were undergone surgery in winter.All the children had success operation.There were no life-threatening malignant adverse events and death cases.The two groups had no statistically significant differences in operation implementation and prognosis;Incidences of adverse events such as cough and phlegm,Sp O2 〈95% and T 》38° in the winter（40.88%,13.30% and 16.25%） were higher than those of the summer（31.02%,4.01%,8.02%,P〈 0.05）;the two groups had no statistically significant differences in incidences of serious adverse events including glossocoma,breath holding,laryngospasm and bronchospasm,etc.;compared to the rest children,the incidence of adverse event in children of summer group who were younger than 1 year was increased by 3.69 times（95% CI：1.84-7.38）,and that of winter group was increased by 2.41 times（95% CI：1.08-5.39）.Conclusion For children undergone general anesthesia in the winter,perioperative adverse events should be paid attention to.At the same time,implementation of general anesthesia on children less than 1 year old is an independent risk factor to anesthesia-related adverse events,which should be given enough attention regardless of the season.
出处
《遵义医学院学报》
2015年第3期289-293,共5页
Journal of Zunyi Medical University
基金
贵州省社会发展科技攻关项目(NO:黔科合SY字[2013]3064)
关键词
全身麻醉
不良事件
危险因素
general anesthesia
adverse events
risk factors
