高龄患者全身麻醉下行非心脏手术围术期并发症及危险因素分析  

Perioperative complications and risk factors of non-cardiac surgery in elderly patients under general anesthesia

作　　者：施燕渲 吴德华 王卫星 唐佳雯 朱涛[1] SHI Yanxuan;WU Dehua;WANG Weixing;TANG Jiawen;ZHU Tao(Department of Anesthesiology,Shanghai Songjiang District Central Hospital,201600,Shanghai,China)

机构地区：[1]上海市松江区中心医院麻醉科,上海201600

出　　处：《大医生》2023年第9期1-5,共5页Doctor

基　　金：上海市医学重点专科建设项目(编号:ZK2019C11)。

摘　　要：目的探讨在全身麻醉下行非心脏手术的高龄患者围术期并发症发生率,并分析其危险因素。方法回顾性分析2020年1月至2021年12月于上海市松江区中心医院在全身麻醉下行非心脏手术的427例高龄患者的临床资料,根据是否发生并发症分为发生组(57例)和未发生组(370例),采用单因素和多因素回归分析明确术后并发症发生的危险因素。结果57例(13.35%)患者发生术后并发症。发生组患者术中累计低血压时间长于未发生组,入ICU比例、ICU停留时间及住院时间多于未发生组。多因素Logistic回归分析显示,长时间手术、术前肾功能不全、术后入ICU及术后更长的ICU停留时间是术后总体并发症增加的独立危险因素(P<0.05)。结论全身麻醉行非心脏手术的高龄患者围术期具有较高的并发症发生率。术前肾功能不全、长时间手术、术后入ICU及术后更长的ICU停留时间是导致术后并发症增加的独立危险因素,临床应加以重视。Objective To investigate the incidence of perioperative complications of non-cardiac surgery in elderly patients under general anesthesia and analyze its risk factors.Methods A total of 427 elderly patients undergoing non-cardiac surgery under general anesthesia were reviewed between January 2020 and December 2021 at Shanghai Songjiang District Central Hospital.Patients were divided into both of complication group(57 cases)and non-complication group(370 cases)based on whether postoperative complications were developed or not.Univariate and multivariate analyses were performed to identify risk factors for postoperative complications.Results Postoperative complications occurred in 57 patients(13.35%).Compared with patients in non-complication group,those patients in complication group experienced longer duration of intraoperative hypotension.The rate of ICU admit,ICU stay and length of hospital stay were higher or longer.Multivariable logistic analysis identified increased operation time,preoperative renal dysfunction,ICU admit and longer ICU stay as risk factors of postoperative complications(P<0.05).Conclusion Elderly patients undergoing non-cardiac surgery under general anesthesia have a higher incidence of perioperative complications.Preoperative renal insufficiency,prolonged operation,ICU admit and longer ICU stay are independent risk factors for increased postoperative complications,which should be paid attention in clinical work.

关 键 词：高龄 全身麻醉 非心脏手术 并发症 

分 类 号：R614.2[医药卫生—麻醉学]