中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2013年
12期
1427-1430
,共4页
手术后并发症%插管法,气管内%危险因素%麻醉,全身
手術後併髮癥%插管法,氣管內%危險因素%痳醉,全身
수술후병발증%삽관법,기관내%위험인소%마취,전신
Postoperative complications%Intubation,intratracheal%Risk factors%Anesthesia,general
目的 筛选全麻患者术后再次气管插管的危险因素.方法 选择本院2010年1月至2012年12月麻醉后恢复室的全麻术后患者46 507例,年龄18～83岁,性别不限,将再次气管插管的患者作为再次气管插管组.按1∶5比例随机抽取同时期进入麻醉后恢复室无再次气管插管的患者,年龄18～83岁,作为对照组.记录患者一般资料、手术相关因素:手术类型(急诊/择期),手术部位(头颈部、气道、胸内、上腹部、下腹部、其他部位)和手术时间;麻醉相关因素:术毕前30 min内阿片类药物和肌松药物、术毕新斯的明的使用情况,将组间差异有统计学意义的因素进行logistic回归分析,筛选术后再次气管插管的危险因素.结果 32例患者术后再次气管插管,发生率为0.069％.2组患者年龄、性别、BMI、ASA分级、术前SpO2、合并术前2周内上呼吸道感染、慢性阻塞性肺疾病(COPD)、全身性炎症反应综合征(SIRS)和低蛋白血症、手术部位和手术时间比较差异有统计学意义(P ＜0.05或0.01).logistic回归分析结果显示:ASA分级≥Ⅲ级、合并COPD和SIRS、胸内手术是全麻患者术后再次气管插管的危险因素.结论 ASA分级≥Ⅲ级、合并COPD和SIRS、胸内手术是全麻患者术后再次气管插管的危险因素.
目的 篩選全痳患者術後再次氣管插管的危險因素.方法 選擇本院2010年1月至2012年12月痳醉後恢複室的全痳術後患者46 507例,年齡18～83歲,性彆不限,將再次氣管插管的患者作為再次氣管插管組.按1∶5比例隨機抽取同時期進入痳醉後恢複室無再次氣管插管的患者,年齡18～83歲,作為對照組.記錄患者一般資料、手術相關因素:手術類型(急診/擇期),手術部位(頭頸部、氣道、胸內、上腹部、下腹部、其他部位)和手術時間;痳醉相關因素:術畢前30 min內阿片類藥物和肌鬆藥物、術畢新斯的明的使用情況,將組間差異有統計學意義的因素進行logistic迴歸分析,篩選術後再次氣管插管的危險因素.結果 32例患者術後再次氣管插管,髮生率為0.069％.2組患者年齡、性彆、BMI、ASA分級、術前SpO2、閤併術前2週內上呼吸道感染、慢性阻塞性肺疾病(COPD)、全身性炎癥反應綜閤徵(SIRS)和低蛋白血癥、手術部位和手術時間比較差異有統計學意義(P ＜0.05或0.01).logistic迴歸分析結果顯示:ASA分級≥Ⅲ級、閤併COPD和SIRS、胸內手術是全痳患者術後再次氣管插管的危險因素.結論 ASA分級≥Ⅲ級、閤併COPD和SIRS、胸內手術是全痳患者術後再次氣管插管的危險因素.
목적 사선전마환자술후재차기관삽관적위험인소.방법 선택본원2010년1월지2012년12월마취후회복실적전마술후환자46 507례,년령18～83세,성별불한,장재차기관삽관적환자작위재차기관삽관조.안1∶5비례수궤추취동시기진입마취후회복실무재차기관삽관적환자,년령18～83세,작위대조조.기록환자일반자료、수술상관인소:수술류형(급진/택기),수술부위(두경부、기도、흉내、상복부、하복부、기타부위)화수술시간;마취상관인소:술필전30 min내아편류약물화기송약물、술필신사적명적사용정황,장조간차이유통계학의의적인소진행logistic회귀분석,사선술후재차기관삽관적위험인소.결과 32례환자술후재차기관삽관,발생솔위0.069％.2조환자년령、성별、BMI、ASA분급、술전SpO2、합병술전2주내상호흡도감염、만성조새성폐질병(COPD)、전신성염증반응종합정(SIRS)화저단백혈증、수술부위화수술시간비교차이유통계학의의(P ＜0.05혹0.01).logistic회귀분석결과현시:ASA분급≥Ⅲ급、합병COPD화SIRS、흉내수술시전마환자술후재차기관삽관적위험인소.결론 ASA분급≥Ⅲ급、합병COPD화SIRS、흉내수술시전마환자술후재차기관삽관적위험인소.
Objective To identify the risk factors for postoperative reintubation in patients undergoing general anesthesia.Methods Forty-six thousand five hundred and seven patients,aged 18-83 yr,requiring reintubation after planned extubation in the postanesthesia care unit (PACU) of our hospital from January 2010 to December 2012,served as reintubation group.Patients in a 1∶5 ratio,aged 18-83 yr,admitted to the PACU of our hospital from January 2010 to December 2012,with successful extubation,served as control group.The general data of patients and operation-related factors including type of operation (emergency operation/elective operation),operative sites (head and neck,airway,within the chest,upper abdomen,lower abdomen,other sites) and operation time and anesthesia-related factors including requirement for opioids and muscle relaxants within 30 min before operation,and for neostigmine at the end of operation were recorded.The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify reintubation-related risk factors.Results Thirty-two patients were reintubated after operation and the incidence was 0.069％.There was significant difference in age,gender,body mass index,ASA physical status,preoperative SpO2,complication with upper respiratory infections within 2 weeks before operation,chronic obstructive pulmonary disease (COPD),or systemic inflammatory response syndrome (SIRS) and hypoproteinemia,operative sites and operation time between the two groups (P ＜ 0.05 or 0.01).The logistic regression analysis showed that ASA physical status ≥ Ⅲ,complication with COPD or SIRS,and thoracic surgery were closely correlated with postoperative reintubation in patients undergoing general anesthesia.Conclusion ASA physical status ≥ Ⅲ,complication with COPD or SIRS,and thoracic surgery are risk factors for postoperative reintubation in patients undergoing general anesthesia.
