广西部分医院椎管内麻醉神经并发症发生率及治愈情况初步调查  

A preliminary analysis on the incidence and cure rate of neurological complications after intrathecal anesthesias in Guangxi hospitals

作　　者：秦明钦[1] 何亚军[2] 

机构地区：[1]广西医科大学第一附属医院西院ICU科,广西南宁530007 [2]广西医科大学第一附属医院麻醉科,广西南宁530021

出　　处：《蛇志》2013年第3期265-267,共3页Journal of Snake

摘　　要：目的对广西各级医院椎管内麻醉后神经损伤并发症发生率及治愈情况进行初步分析。方法收集广西全区各级医院椎管内麻醉神经损伤并发症调查表,根据人口统计学和临床特征计算麻醉相关并发症的发生率及治愈率,并进行统计学分析。结果椎管内麻醉神经并发症的发生率为0.0408%,其中以短暂神经综合征(TNS)为最多,发生率为0.0340%,其次是脊神经损伤,发生率为0.0050%,其他三种类型的并发症较为少见。硬膜外麻醉出现的神经并发症最少,与其他两种麻醉方式比较,差异有统计学意义(P<0.005)。神经并发症总康复率为89.8%,硬膜外麻醉、腰硬联合麻醉、腰麻神经并发症完全康复率分别为87.80%、90.26%、90.0%,差异无统计学意义(P>0.05)。所有短暂神经综合征病人均完全康复(100%),而脊神经损伤只有48%病人完全康复,马尾综合征只有25%病人完全康复,截瘫、前脊髓综合征、硬膜外血肿这三类病人均无完全康复病例,出现了永久性损伤(P<0.05)。结论与椎管内麻醉相关的并发症发生率较低,硬膜外麻醉的神经并发症最少。大多数的神经并发症是可以完全治愈的,但严重性、永久性的损伤是灾难性的。Objective To learn the use of intrathecal anesthesia at all levels in Guangxi hospitals and to carry out a preliminary analysis of neurological complications after intrathecal anesthesia. Methods Collect neurological complications questionnaire at all levels in Guangxi hospitals based on the demographic and clinical features of anes- thesia-related complications,and to calculate the incidence and cure rate of neurological complications,and to analy- sis them. Results The incidence of neurological complications after intrathecal anesthesia was 0. 0408%,the in- cidence of TNS was the most （0. 0340%）,followed by spinal nerve injury （0. 0050%）,the other three types of complications were relatively rare. The incidence of neurological complication after epidural anesthesia was the least, the difference was statistically significant （P〈0. 05）. The total cure rate of neurological complications was 89.8% ,the cure rate of three anesthesia were 87.80% ,90. 26% ,90.0% ,respectively. The difference was not sta- tistically significant （P〉0. 05）. All TNS patients were fully recovered （100 %）. 48 % in spinal nerve injury, 25% in cauda equina syndrome, the other three types complication of patients developed permanent damage. Conclusion The incidence of intrathecal anesthesia-related complications is very low. The neurological complications of epidural anesthesia was the least. Most of the neurological complications could be completely cured, but the severity of the injury is permanent catastrophic.

关 键 词：椎管内麻醉 神经并发症 回顾性分析 

分 类 号：R614[医药卫生—麻醉学]