小儿手术后早期低氧血症与麻醉恢复评分的相关性  

Correlation of Postanesthesia Recovery Score with Early Postoperative Hypoxemia in Children

作　　者：张国华[1] 薛富善[1] 李平[1] 孙海涛[1] 刘鲲鹏[1] 廖旭[1] 佟世义[1] 张雁鸣[1] 刘建华[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院麻醉科,北京100041

出　　处：《实用儿科临床杂志》2006年第11期658-659,704,共3页Journal of Applied Clinical Pediatrics

基　　金：卫生部中青年优秀人才专项基金项目资助(97004)

摘　　要：目的 研究小儿手术后早期低氧血症与麻醉恢复评分（PARS）相关性。方法 选择按美国麻醉医师协会（ASA）身体状态分级为Ⅰ级、年龄3个月～14岁拟行择期体表整形外科手术患儿1213例。手术均是在静吸复合全身麻醉下实施。在患儿到达麻醉恢复室即刻（0min）和5、10、15、20、30、40、50、60、120和180min时，记录呼吸空气状态下Sp（O2）值，并同时行PARS评估。根据不同PARS将患儿分为3组：Ⅰ组PARS≤6分；Ⅱ组PARS为7～9分；Ⅲ组PARS=10分。结果 患儿术后早期PARS越低，其低氧血症和严重低氧血症发生率越高。3组术后早期低氧血症发生率有显著差异（P均〈0．05）。结论 PARS与手术后早期低氧血症发生率和严重程度密切相关。对于PARS为10分的患儿，术后早期阶段可不必常规予吸氧治疗。Objective To observe the correlations of the postanesthesia recovery score（PARS） with the incidence, and severity of early postoperative hypoxemia in children. Methods One thousand two hundred and thirteen infants and children,American Society of Anesthesiologists（ASA） physical status Ⅰ , aged 3 months to 14 years, scheduled for elective plastic surgery were included in this study. All of operations were performed under combined intravenous-inhalation anesthesia. Arterial oxygen saturation Sp（O2） levels were recorded while children were breathing room air shortly after arrival in the recovery room （0 min） ,and 5,10, 15,20,30,40,50,60,120 and 180 min thereafter. The PARS were also determined on all patients when Sp（O2） levels were recorded in the recovery room. On the basis of different PARS,children were divided into 3 groups：group Ⅰ ,children with PARS of less than 6;groupⅡ ,children with PARS of 7 - 9;and group Ⅲ, children with PARS of 10. Results During early postoperative period, the lower the children＇s PARS, the higher the incidences of hypoxemia Sp（O2） = 86% - 90% and severe hypoxemia Sp（O2）≤85 %, The incidences of hypoxemia and severe hypoxemia were significant differences among three groups. Conclusions The incidehce and severity of hypoxemia correlate closely with children＇s PARS. The routine oxygen supplement isn＇t necessary for a patient with a PARS of 10 because hypoxemia will not occur.

关 键 词：麻醉 低氧血症 手术后早期 血氧饱和度 麻醉恢复评分 儿童 

分 类 号：R726.1[医药卫生—儿科]