Pierre Robin序列征婴儿下颌骨牵引成骨术后机械通气时间影响因素的回顾性分析  

Anaysis of influencing factors of mechanical ventilation time in infants with Pierre Robin sequence after mandibular distlaction osteogenesis

作　　者：张娜[1] 毛喆 崔颖秋[2] 张欢欢[1] 徐颖怡 ZHANG Na;MAO Zhe;CUI Yingqiu;ZHANG Huanhuan;XU Yingyi(Department of Anaesthesia and Perioperative period,Guangzhou Women and Children′s Medical Center,Guang⁃zhou 510623,China)

机构地区：[1]广州医科大学附属广州市妇女儿童医中心麻醉与围术期科,广州510623 [2]广州医科大学附属广州市妇女儿童医中心口腔颌面外科,广州510623

出　　处：《实用医学杂志》2019年第24期3837-3841,共5页The Journal of Practical Medicine

基　　金：广州市卫生健康科技项目(编号：20191A011034)

摘　　要：目的分析Pierre Robin序列征婴儿下颌骨牵引成骨术后机械通气时间的影响因素。方法回顾性分析广州市妇女儿童医疗中心2016年11月至2018年8月接受下颌骨牵引成骨术的Pierre Robin序列征婴儿73例。从医院信息系统中提取相关数据,包括:性别、年龄、体质量指数百分位数、早产史、术前肺部感染、喉软化/气管支气管软化、术前气管插管、术前喉镜暴露分级、麻醉时间、手术时间、术后转入科室、下颌骨牵引情况、术后呼吸道并发症和机械通气持续时间。采用独立样本t检验和Pearson线性相关分析,研究相关因素与机械通气时间的潜在相关性。结果平均机械通气时间为138.5 h;各种二元变量的t检验分析表明:性别、早产史、术前肺部感染、心脏疾病、喉软化/气管支气管软化、术前气管插管、喉镜暴露困难、呼吸机相关性肺炎术后机械通气时间组间差异均无统计学意义(P>0.05);连续变量的Pearson线性相关分析表明:拔管时牵引距离与术后机械通气时间相关性高(r=0.951),相关系数的t检验显示二者呈直线相关(P<0.05)。结论对于接受下颌骨牵引成骨的Pierre Robin序列征婴儿,术后机械通气时间跟拔管时牵引距离高度相关。Objectives To identify factors influencing the mechanical ventilation(MV)time in infants with Pierre Robin sequence after mandibular distraction osteogenesis(MDO). Methods A retrospective analysis was performed on 75 infants who received MDO from November 2016 to August 2018 with Pierre Robin sequence. Data extracted from the hospital information system included sex,age,BMI%,history of preterm labor,preoperative pulmonary infection,laryngomalacia/tracheomalacia,laryngoscope exposure classification,anesthesia duration,operation duration,postoperative treatment site,situation of distraction,postoperative complications and MV duration. Independent-samples t test and Pearson′s linear correlation analyses were conducted to investigate the potential associations of these factors with MV time. Results Mean MV time was 138.5 h. The t-test analysis of various binary variables showed that there were no significant differences in gender,history of premature birth,preoperative pulmonary infection, laryngomalacia/tracheobronchial malacia, preoperative tracheal intubation,difficulty in laryngoscopy exposure,and post-operative mechanical ventilation time for ventilator-associated pneumonia(P > 0.05). The Pearson linear correlation analysis of continuous variables showed that there was a high correlation between the traction distance at extubation and the time of mechanical ventilation after operation(r =0.951). The t-test of correlation coefficient showed a linear correlation between them(P < 0.05). Conclusions According to this analysis,the time of mechanical ventilation was highly correlated with the distance of traction following MDO for severe Pierre Robin sequence.

关 键 词：下颌骨牵张成骨 Pierre Robin序列征 机械通气 婴儿 

分 类 号：R47[医药卫生—护理学]