摘要
目的采用Logistic回归分析探讨小儿喉部疾患术中麻醉主要不良事件的相关影响因素。方法收集喉部疾患患儿88例,对所有患儿的相关因素进行定义和记录,包括:性别、年龄、体重、初次发病年龄、手术次数、呼吸道梗阻程度、疾病部位、疾病性质、是否合并肺炎、是否合并先天性心脏病、术前是否气管切开、是否气管插管下手术。此类手术术中主要麻醉不良事件包括:SpO2下降(SpO2<90%)、HR减慢(减慢≥基础值30%)、术中手术部位出血(≥5ml)。对影响麻醉主要不良事件的相关因素进行Logistic回归分析,用OR值和95%可信区间(CI)评价相关性。结果呼吸道梗阻程度和合并肺炎是SpO2下降的危险因素,95%CI分别为(4.164～83.262)、(5.358～518.580);呼吸道梗阻程度、合并肺炎和合并先天性心脏病是HR减慢的危险因素,95%CI分别为(3.036～43.094)、(1.886～52.508)、(1.118～27.100);初次发病年龄大和气管插管下手术是术中出血的保护因素,95%CI分别为(0.095～1.050)、(0.004～0.294)。结论呼吸道梗阻程度和合并肺炎是SpO2下降和HR减慢的危险因素;初次发病年龄大和气管插管下手术是术中出血的保护因素。
Objective To explore the risk factors involved in anesthesia adverse events during pediatric laryngeal surgery with Logistic regression. Methods We collected 88 pediatric laryngeal surgery cases. The main medical related factors were defined as gender, age, weight, first onset age, previous operation times, degree of respiratory obstruction, the site and category of disease, pneumonia, congenital heart disease, preoperative tracheotomy, and endotracheal intubation. The main anesthesia adverse events were hypoxemia（SpO2 〈 90%）, bradycardia （less than 30% of baseline heart rate）, bleeding（more than 5 ml）. These anesthesia adverse events related risk factors were analyzed by Logistic regression analysis. Odds ratio （OR） and 95% confidence interval （CI） were used to evaluate the results. Results Respiratory obstruction and pneumonia were risk factors involved in hypoxemia 95% CI： （ 4. 164-83. 262, （ 5. 358-518. 580）. Respiratory obstruction, pneumonia and congenital heart disease were risk factors involved in bradycardia 95% CI： （3. 036- 43. 094）, （1. 886-52. 508）, （1. 118-27. 100）. The older onset age and endotracheal intubation were intraoperative bleeding protection factors 95% CI.. （0. 095-1. 050）, （0. 004-0. 294）. Conclusion Risk factors for hypoxemia and bradycardia are respiratory obstruction and pneumonia. Older onset age and preoperative tracheotomy are protective factors for intraoperative bleeding.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2013年第6期542-545,共4页
Journal of Clinical Anesthesiology
