影响唇腭裂修复术患儿全麻后快速恢复相关因素的回顾性分析  

A retrospective analysis of factors influencing post-anesthesia rapid recovery after pediatric cleft lip and/or palate repair

作　　者：张砡[1] 朱波[1] 宋锴澄[1] 虞雪融[1] 张羽冠[1] 张爱华 郑茂灿 ZHANG Yu;ZHU Bo;SONG Kaicheng;YU Xuerong;ZHANG Yuguan;ZHANG Aihua;ZHENG Maocan(Department ol Anesthesiology,Peking Union Medical College Hospital,Chinese Academy ol Medical Science ＆ Peking Union College,Beijing 100730,China;Department ol Anesthesiology,the People’s Hospital ol Linqing,Liaocheng Shandong 252600,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院麻醉科,北京100730 [2]临清市人民医院麻醉科,山东聊城252600

出　　处：《转化医学杂志》2018年第3期153-155,193,共4页Translational Medicine Journal

基　　金：公益性行业科研专项(201402017)

摘　　要：目的分析3岁以内小儿行全麻下唇腭裂修补术全麻后快速恢复的相关影响因素。方法回顾性分析北京协和医院2013年1月—2016年12月3岁以内行全麻下唇腭裂修补术患儿314例,根据患儿拔除气管导管至满足麻醉恢复室离室标准返回病房的时间是否超过30 min,将患儿分为快速恢复组和非快速恢复组,比较2组患儿一般资料、术前合并疾病、手术麻醉相关资料等,并对可能影响术后快速恢复的因素进行多因素Logistic回归分析。结果与快速恢复组比较,非快速恢复组的患儿月龄较小(P<0.01)、体重较低(P<0.01)、气管插管ID号偏小(P<0.01)、腭裂修补术比例较低(P<0.01)、术前合并呼吸系统异常比例较高(P<0.01)。多因素Logistic回归分析显示患儿术前合并呼吸系统异常(OR=5.622,95%CI=1.650~19.158)是术后无法快速恢复的独立预测因素。结论术前合并呼吸系统异常是3岁以内患儿全麻下行唇腭裂修补术术后无法快速恢复的独立危险因素。Objective To investigate the predictors for rapid postoperative recovery from general anesthesia（ GA） in children less than three-year old receiving repair of cleft lip or palate.Methods Totally 314 children less than three years old,who received repair of cleft lip or palate under GA in Peking Union Medical Collegc Hospital from Jan 2013 to Dec 2016,were divided into two groups according to the time from extubation to discharge from operation room and back to ward.Rapid recovery from GA were defined as the recovery time less than 30 min. All the records,including demographics,preoperative coexist diseases,the parameters of anesthesia and operation,were compared between these two groups. The multivariate logistic regression analysis was used to survey the potential risk factors. Results When compared with the rapid recovery group,children in the non-rapid recovery group had significantly smaller age,lower body weight,smaller tracheal tube ID,less proportion of cleft palate repairment,and higher rate of preoperative respiratory coexist diseases（ P〈0. 01）. The multivariate logistic regression analysis showed that preoperative respiratory coexist diseases was the independent predictors for non-rapid recovery from GA（ OR = 5. 622,95% CI =1. 650 ~ 19. 158）. Conclusion Preoperative respiratory coexist diseases is an independent predictors for non-rapid recovery from GA in children 3 years old receiving repair of cleft lip or palate.

关 键 词：全身麻醉 唇腭裂修补术 快速术后恢复 儿童 

分 类 号：R726.14[医药卫生—儿科]