术中唤醒麻醉脑功能区神经外科手术患者术后麻醉并发症发生情况及相关影响因素分析  

Anesthetic Complications and Influencing Factors in Patients Undergoing Neurosurgical Surgery after Intraoperative Awakening of Brain Function Area under Anesthesia

作　　者：边兴花 刘东辉 赵生虎 辛世敏 赵庆忠 龚盛龙 BIAN Xing-hua;LIU Dong-hui;ZHAO Sheng-hu;XIN Shi-min;ZHAO Qing-zhong;GONG Sheng-long(Department of Anesthesiology, the First Hospital of Zhangjiakou, Zhangjiakou, Hebei 075000, China;Department of Neurosurgery, Yanjiao People's Hospital in Sanhe, Langfang, Hebei 065201, China;Department of Surgery, the People's Hospital of Wanquan District in Zhangjiakou, Zhangjiakou, Hebei 076250, China)

机构地区：[1]张家口市第一医院麻醉科,河北张家口075000 [2]三河市燕郊人民医院神经外科,河北廊坊065201 [3]张家口市万全区医院外科,河北张家口076250

出　　处：《临床误诊误治》2019年第6期72-75,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生和计划生育委员会科研基金项目(20181173)

摘　　要：目的:探讨术中唤醒麻醉脑功能区神经外科手术患者术后麻醉并发症发生情况及相关影响因素。方法:选取2014年1月-2015年6月我院行术中唤醒麻醉脑功能区神经外科手术92例作为研究对象,根据术后有无麻醉并发症发生,分为并发症组、无并发症组。记录术后麻醉并发症发生情况,采用logistic回归分析观察影响术中唤醒麻醉脑功能区神经外科手术患者术后麻醉并发症发生的相关危险因素。结果:本研究31例出现术后麻醉并发症,发生率为33.70%,其中躁动17例(18.48%),恶心呕吐5例(5.43%),寒战3例(3.26%),心律失常、呼吸道梗阻、苏醒延迟各2例(2.17%)。本文并发症组31例,无并发症组61例。经单因素logistic回归分析显示,年龄、合并疾病、麻醉药物使用类型、术前美国麻醉医师协会(american society of anesthesiologists, ASA)分级、术后48 h视觉模拟评分(visual analogue score, VAS)是影响术中唤醒麻醉脑功能区神经外科手术患者术后麻醉并发症发生的相关因素( P <0.05)。多因素logistic回归分析显示,年龄≥60岁、麻醉药物使用依托咪酯、术前ASA分级Ⅱ级~Ⅲ级、术后48 h VAS评分≥5分是影响术中唤醒麻醉脑功能区神经外科手术患者术后麻醉并发症发生的独立危险因素( P <0.05)。结论:术中唤醒麻醉脑功能区神经外科手术患者术后躁动较为常见,年龄、麻醉药物使用类型、术前ASA分级、术后48 h VAS评分为影响术后麻醉并发症发生的独立危险因素,临床应高度重视。Objective To investigate the anesthetic complications and influencing factors in patients undergoing neurosurgical surgery after intraoperative awakening of brain function area under anesthesia. Methods From January 2014 to June 2015, 92 patients receiving neurosurgical surgery after intraoperative awakening of brain function area under anesthesia in our hospital were selected as the research objects. According to presence or absence of anesthesia complications after operation, the patients were divided into two groups: complication group and non-complication group. The incidence of postoperative anesthesia complications was recorded. Logistic regression analysis was used to observe the related risk factors affecting occurrence of postoperative anesthesia complications in patients undergoing neurosurgical surgery after awakening brain function area under anesthesia during operation. Results In this study, 31 cases showed postoperative anesthesia complications, and the incidence rate was 33.70%, including restlessness ( n =17, 18.48%), nausea and vomiting ( n = 5, 5.43%), chills ( n =3, 3.26%), arrhythmia ( n =2, 2.17%), airway obstruction ( n =2, 2.17%), and delayed regain consciousness ( n =2, 2.17%). Of these, 31 cases were found in complication group and 61 in non-complication group. Univariate logistic regression analysis showed that gender, combined disease, type of anesthetics used, preoperative American Society of Anesthesiologists (ASA) grade, and visual analogue score (VAS) 48 h after surgery were related factors affecting the occurrence of postoperative anesthesia complications in patients with neurosurgical surgery after awakening brain function area under anesthesia during operation ( P >0.05). Multivariate logistic regression analysis showed that age (≥60 years of age), type of anesthetics used (Etomidate fat emulsion), preoperative ASA grade (grade II to III), VAS score 48 h after surgery (≥5 points) were independent risk factors affecting the occurrence of postoperative anesthesia complications

关 键 词：术中唤醒 神经外科手术 手术后并发症 影响因素分析 

分 类 号：R619.9[医药卫生—外科学]