摘要
目的 回顾性分析心包积液患儿围术期不良事件的影响因素.方法 我院2009年1月至2014年7月手术治疗的心包积液患儿157例,麻醉期间不良事件定义为诱导后出现低氧、低血压或心律失常.应用单因素和多因素Logistic回归分析不良事件的危险因素.结果 有38例（24.2％）患儿发生不良事件（A组）,其中一般不良事件31例（81.6％）,严重不良事件7例（18.4％）.A组术前合并胸腔积液、呼吸困难、奇脉、心房/心室压迫、较高ASA分级及入手术室时呼吸急促、心动过速、低氧、低血压明显多于无不良事件组（N组）（P＜0.05）.多因素Logistic回归分析显示,术前呼吸困难（OR=6.8,95％CI 1.4～12.4）、入手术室时低氧（OR=5.5,95％CI 1.1～15.9）、入手术室时低血压（OR=3.4,95％CI 1.2～9.1）及心房/心室压迫（OR=6.3,95％CI 1.8～22.1）是不良事件的独立危险因素.结论 对存在危险因素的心包积液患儿应警惕其麻醉期间发生不良事件.
Objective To identify the risk factors associated with adverse events during general anesthesia in pediatric pericardial effusion surgery. Methods Medical records of 157 children for sur gical treatment under general anesthesia for pericardial effusion in Children＇s Hospital of Chongqing Medical University from January 2009 to July 2014 were collected and retrospectively analyzed. Univariate analysis and multivariate logistic regression analysis were used to investigate the risk factors of adverse events during general anesthesia. Results Overall adverse events rate was 24. 2% （38/157）, in which 31 （81.6%） suffered minor adverse events, and 7 （18.4%） suffered major adverse events during general anesthesia. For the univariate analysis, adverse events during general anesthesia associated with preoperative pleural effusion, dyspnea, pulsus paradoxus, atrial/ventricular collapse, the higher ASA anesthesia classification, and tachypnea, tachycardia, hypoxia, hypotension before anes- thesia induction （P〈0. 05）. Multivariate logistic regression analysis indicated that the risk factors of adverse events during anesthesia were preoperative dyspnea （OR： 6.8, 95%CI 1.4-12.4）, hypoxia （OR=5.5, 95 %CI 1.1-15.9） and hypotension （OR=3.4, 95%CI 1.2-9.1） before anesthesia induc- tion, and atrial/ventricular collapse （OR= 6.3, 95 % CI 1.8-22.1） on preoperative echocardiogram. Conclusion The risk factors associated with pediatric pericardial effusion surgery should alert the an- esthetist to the possibility of adverse events during general anesthesia.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2015年第4期368-371,共4页
Journal of Clinical Anesthesiology
基金
国家临床重点专科建设项目(国卫办医函[2013]544)
关键词
心包积液
全身麻醉
小儿
不良事件
Pericardial effusion
Gencral anesthesia
Child
Adverse events
作者简介
通信作者：徐颖，Email：yingxu866@126．com
