上呼吸道感染患儿全麻术后的临床风险分析  

Clinical risk of children with upper respiratory tract infections undergoing general anesthesia

作　　者：刘青华[1] 胡晋怀[2] 徐强[1] 柳波[1] 刘本娟[1] 

机构地区：[1]临沂市人民医院麻醉科,山东临沂276000 [2]临沂市人民医院检验科,山东临沂276000

出　　处：《中华医院感染学杂志》2016年第18期4231-4233,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(Y2006CD2)

摘　　要：目的探讨轻中度上呼吸道感染患儿全身麻醉后呼吸系统并发症发生情况,评估实施全身麻醉的安全性,为临床治疗提供依据。方法选取医院2014年1-12月四肢开放外伤患儿148例,年龄30d^14岁,依据患儿体征、术前上呼吸道感染症状,将其分为3组:中度上呼吸道感染组(URI)20例,轻度URI26例,非URI组98例;分别于手术期、术后1d对患儿呼吸系统并发症发生率进行评估比较,应用统计软件SPSS20.0对数据进行分析。结果术期与术后咳嗽、多痰、舌后坠、支气管痉挛、体温≥38℃、SpO2,3组之间比较差异均无统计学意义;中度URI组与非URI组相比,屏气发生率增高,差异有统计学意义(P<0.05);中度URI组与轻度URI相比,其咳嗽发生率增高差异有统计学意义(P<0.05);年龄4~14岁患儿在手术中心率变化,中度URI组与非URI组相比,差异有统计学意义(P<0.05),在≤3岁患儿中,轻度URI组明显低于中度URI组,差异有统计学意义(P<0.05)。结论四肢开放外伤患儿中度URI患儿并发症发生率明显升高,建议针对合并轻中度上呼吸道感染全身麻醉的患儿治疗前进行全面风险评估,对实施全身麻醉需慎重,杜绝意外医疗事故的发生。OBJECTIVE To explore the incidence of respiratory system complications in children with mild to moderate upper respiratory tract infections after general anesthesia and assess the safety of the general anesthesia so as to provide guidance for clinical treatment.METHODS A total of 148 children with limb open trauma,aged from 30 days to 14 years old,who were treated in the hospital from Jan 2014 to Dec 2014,were enrolled in the study and divided into the three groups according to the body signs,symptoms of preoperative upper respiratory tract infections：the moderate upper respiratory tract infection（URI）group with 20 cases,mild URI group with 26 cases,and non-URI group with 98 cases.The incidence of respiratory system complications was assessed and compared among the children during the surgery or after the surgery for one day,and the statistical analysis of data was performed with the use of SPSS20.0software.RESULTS There was no significant difference in the cough,phlegm,glossoptosis,bronchospasm,body temperature no less than 38 ℃,or SpO2 among the three groups during the surgery or after the surgery.The incidence of holding breath was increased,and there was significant difference between the moderate URI group and the non-URI group（P〈0.05）.There was significant difference in the increase of incidence of cough between the moderate URI group and the mild URI group（P〈0.05）.As compared with the change of intraoperative heart rate among the children aged from 4to 14 years old,there was significant difference between the moderate URI group and the non-URI group（P〈0.05）;among the children aged no more than 3years old,the mild URI group was significantly lower than that of the moderate URI group（P〈0.05）.CONCLUSIONThe incidence of complications is remarkably increased in the limb open trauma children with moderate URI,and it is suggested that the comprehensive risk assessment should be conducted for the general anesthesia children complicated with mild to moderate upper respiratory tract i

关 键 词：患儿 上呼吸道感染 全身麻醉 呼吸系统 并发症 

分 类 号：R614.1[医药卫生—麻醉学]