高龄患者全身麻醉术后发生并发症的危险因素分析  

Relevant Risk Factors Analysis for Perioperative Complications of Elderly Patients with General Anesthesia

作　　者：李雪娇[1] 杨晶[2] 孟晓敏[1] 孟霞[1] 肖映红[1] 

机构地区：[1]解放军总医院南楼肿瘤内科,北京100853 [2]解放军总医院南楼护理部

出　　处：《解放军护理杂志》2015年第2期27-30,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的研究高龄患者全身麻醉术后发生并发症的危险因素,以期为制定合适的护理措施提供临床依据。方法回顾性分析2008年1月至2013年8月,在解放军总医院南楼行全身麻醉手术的80岁以上高龄患者108例的临床资料,主要包括基础疾病、术前体质量指数(body mass index,BMI)、术后留置管道情况、禁食时间、并发症情况等。按照是否发生术后并发症将其分为A、B两组,A组(n=63)为发生并发症组,B组(n=45)为未发生并发症组,分析导致并发症发生的危险因素。结果高龄患者全身麻醉术后发生并发症63例,占58.3%。单因素分析显示,A、B两组患者在有无心血管疾病、肺功能不全,术后是否留置胃管、尿管、PICC管、大静脉置管以及留置管道的数量、禁食时间上的差异均有统计学意义(均P<0.05)。通过Logistic逐步多元回归分析,术前有心血管疾病、肺功能不全,术后留置胃管、尿管、PICC管、大静脉置管及术后长时间禁食为高龄患者发生并发症的危险因素(均P<0.05)。结论高龄患者全身麻醉术后并发症发生率较高,应注重心、肺基础疾病患者的护理,促进早期拔管、缩短禁食时间以预防并发症发生。Objective To analyze the relevant risk factors for perioperative complications of elderly patients with general anesthesia, and to provide clinical evidence for setting appropriate nursing measures. Methods Clinical data of 108 aged patients with general anesthesia were analyzed retrospectively. Collecting elderly patients clinical data including basic disease, preoperative BMI, postoperative lien catheter, fast time and complications, and the patients were divided into Group A and Group B based on whether to have postoperative complication. Group A （n =63）was the complication group, and group B （n= 45） was the no complication group. The reasons to cause the relevant risk factors were analyzed. Results During hospitalization, 63 patients suffered from perioperative complication, which accounted 58.3%. Single factor analysis showed that there were statistical significance of whether to have cardiac diseases, pulmonary disease, nasogastric tube, urinary catheter, PICC, CVP indwelling after surgery, and the fast time between two groups（all P〈0.05）. Logistic multiple stepwise regression analysis showed that the preoperative cardiovascular disease, pulmonary insufficiency; postoperative nasogastric tube, urinary catheter, PICC, CVP indwelling, and long fast time were the risk factors of the incidence of complications of elderly patients （all P〈0.05）. Conclusion Incidence of perioperative complication rates of elderly patients is high. We need to pay attention to the patients with cardiac and pulmonary disease, and promote early extubation and shorten the fast time to prevent the incidence of complications.

关 键 词：高龄 全身麻醉 术后并发症 危险因素 

分 类 号：R473.6[医药卫生—护理学]