本文關鍵詞： 呼吸道感染 麻醉 全身 兒童 前瞻性研究　出處：《北京大學學報(醫(yī)學版)》2017年05期 　論文類型：期刊論文

【摘要】：目的:觀察近期上呼吸道感染史對接受全身麻醉的兒童圍術期呼吸系統(tǒng)不良事件風險的影響。方法:選擇2015年11月至2016年5月期間在北京大學第一醫(yī)院接受全身麻醉下眼科擇期手術的232例兒童,術前通過兒童父母填寫問卷的形式采集并記錄兒童的術前基礎資料及相關疾病史,包括性別、年齡、身高、體重、術前2周內(nèi)有無上呼吸道感染史、有無早產(chǎn)史、長期被動吸煙史、經(jīng)常性夜間打鼾史和哮喘病史。同時記錄圍術期相關信息(喉罩成功置入所需的次數(shù)、麻醉時間等),觀察圍術期出現(xiàn)的呼吸不良事件,包括氧飽和度下降、氣道分泌物增加、咳嗽、喉痙攣、支氣管痙攣的發(fā)生情況。應用多因素Logistic回歸模型篩選兒童全身麻醉圍術期呼吸系統(tǒng)不良事件的危險因素。結(jié)果:入選的232例兒童中,術前2周內(nèi)有上呼吸道感染史的占28.0%(65/232),其全身麻醉蘇醒期發(fā)生氧飽和度降低(23.1%vs.12.0%,P=0.034)、氣道分泌物增加(15.4%vs.6.6%,P=0.036)或一種及以上呼吸系統(tǒng)不良事件(32.3%vs.18.6%,P=0.024)的風險增加。多因素Logistic回歸分析顯示,術前2周內(nèi)的上呼吸道感染史(OR=2.021,95%CI:1.023~3.994,P=0.043)和經(jīng)常性夜間打鼾史(OR=3.660,95%CI:1.517~8.832,P=0.004)是兒童圍術期呼吸系統(tǒng)不良事件的獨立危險因素。結(jié)論:術前2周內(nèi)的上呼吸道感染史伴隨兒童圍術期呼吸系統(tǒng)不良事件的風險增加。
[Abstract]:Objective: to observe the effect of recent history of upper respiratory tract infection on perioperative adverse respiratory events in children undergoing general anesthesia. From November 2015 to May 2016, 232 children undergoing elective ophthalmic surgery under general anesthesia in the first Hospital of Peking University were selected. The basic data and related disease history of children were collected and recorded by the form of parents' questionnaire before operation, including gender, age, height, weight, history of upper respiratory tract infection within 2 weeks before operation. History of preterm labor, long-term passive smoking, frequent nocturnal snoring and asthma. Information about perioperative period (number of successful placement of laryngeal mask, duration of anesthesia, etc.) was recorded. Observe perioperative respiratory adverse events, including decreased oxygen saturation, increased airway secretions, cough, and laryngeal spasm. The incidence of bronchiospasm. The risk factors of respiratory adverse events in children during general anesthesia were screened by multivariate Logistic regression model. Results: 232 children were enrolled. The patients with upper respiratory tract infection within 2 weeks before operation had a history of upper respiratory tract infection (28.0%, 65 / 232A), and the oxygen saturation decreased 23.1vs.12.0 during the general anesthesia recovery period (P = 0.034). Airway secretions increased by 15.4vs.6.6cm (0.036) or one or more adverse events of respiratory system (32.3vs.18.6%). Multivariate Logistic regression analysis showed that the history of upper respiratory tract infection within 2 weeks before operation was OR2.021. I have a regular nocturnal snoring history of 3.660 and 95 CI: 1.517 and 8.832. Conclusion: the history of upper respiratory tract infection within 2 weeks before operation increases the risk of perioperative respiratory adverse events in children.
【作者單位】： 北京大學第一醫(yī)院麻醉科;
【分類號】：R726.1
【正文快照】： 兒童的呼吸系統(tǒng)較成人具有顯著不同的解剖結(jié)構和生理特點,發(fā)生圍術期呼吸系統(tǒng)不良事件的風險遠高于成人[1]。當兒童合并活動性上呼吸道感染(upper respiratory tract infections,URI)時發(fā)生圍術期呼吸不良事件的風險將明顯增加[2-10]。URI癥狀消失后數(shù)周內(nèi),由于病毒感染導致的

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