下肢神经阻滞不全的危险因素  

Risk factors for incomplete nerve block in lower extremities

作　　者：贺争光 黄亚萍 刘大为 刘子照 王耀慧 罗颍晗 杨琼 孙志华[2] He Zhengguang;Huang Yaping;Liu Dawei;Liu Zizhao;Wang Yaohui;Luo Yinghan;Yang Qiong;Sun Zhihua(Department of Anesthesiology,Xiangya Hospital of Changde,Changde 415000,China)

机构地区：[1]湘雅常德医院麻醉科,415000 [2]湘雅医院麻醉科,长沙410008

出　　处：《中华麻醉学杂志》2020年第11期1385-1388,共4页Chinese Journal of Anesthesiology

摘　　要：目的筛选下肢神经阻滞不全的危险因素。方法拟行下肢神经阻滞的择期手术患者,记录患者性别、年龄、身高、体重、ASA分级、麻醉前有无躯体疼痛、手术分级、手术体位;根据术中麻醉效果将患者分为2组:下肢神经阻滞完全组(N组)和下肢神经阻滞不全组(I组)。将组间比较差异有统计学意义的因素进行多因素logistic回归分析,筛选下肢神经阻滞不全的危险因素。结果下肢阻滞不全的发生率为34.6%。logistic回归分析结果显示:BMI(>24.0~27.9 kg/m2)、ASA分级(Ⅳ级)、手术分级(三、四级)、手术体位(俯卧位)是下肢神经阻滞不全的独立危险因素,年龄(≥40岁)是保护因素(P<0.05)。结论BMI、ASA分级、手术分级和手术体位是下肢神经阻滞不全的独立危险因素,年龄是保护因素。Objective To identify the risk factors for incomplete nerve block in lower extremities.Methods Patients scheduled for elective surgery requring lower limb nerve block were selected.Their gender,age,height,weight,American Society of Anesthesiologists(ASA)physical status,presence or absence of physical pain before anesthesia,surgical classification and surgical position were recorded.The patients were divided into 2 groups according to the effect of anesthesia during operation:nerve block group(group N)and incomplete nerve block group(group I).The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for incomplete nerve block in lower extremities.Results The incidence of incomplete nerve block in lower extremities was 34.6%.The results of logistic regression analysis showed that body mass index(>24.0-27.9 kg/m2),ASA physical status(IV),surgical classification(grade three and four),and surgical position(prone position)were independent risk factors for incomplete nerve block in lower extremities.Age(≥40 yr)was a protective factor(P<0.05).Conclusion Body mass index,ASA physical status,surgical classification,and surgical position are independent risk factors for incomplete nerve block in lower extremities,and age is the protective factor.

关 键 词：下肢 神经传导阻滞 危险因素 

分 类 号：R614[医药卫生—麻醉学]