动脉导管未闭患儿介入术后麻醉恢复期躁动的相关因素分析  

Analysis of related factors of restlessness during the anesthesia recovery period in children with patent ductus arteriosus after interventional surgery

作　　者：朱建美[1] 林敏[1] 江燕 郑坤 Zhu Jianmei;Lin Min;Jiang Yan;Zheng Kun(Department of Cardiology,Children's Hospital,Zhejiang University School of Medicine,Hangzhou 310052,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属儿童医院心血管内科,杭州310052

出　　处：《中国基层医药》2024年第4期528-532,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省教育厅一般科研项目(Y201942119)。

摘　　要：目的探究动脉导管未闭患儿介入术后麻醉恢复期躁动的相关因素。方法回顾性分析浙江大学医学院附属儿童医院2019年11月至2020年10月收治的行心导管介入治疗动脉导管未闭的患儿92例的临床资料。根据麻醉恢复期是否发生躁动分为对照组(67例,未发生躁动)和观察组(25例,发生躁动)。收集对比两组患者的临床资料,单因素及多因素分析动脉导管未闭患儿介入术后麻醉恢复期发生躁动的独立危险因素。结果单因素分析结果显示,两组性别、年龄、气质类型、手术时间、复苏室停留时间、麻醉恢复期血压、麻醉恢复期心率、麻醉恢复期血氧饱和度比较,差异均无统计学意义(均P>0.05);术中应用右美托咪定、术前焦虑、术后疼痛、使用拮抗剂是动脉导管未闭患儿介入术后麻醉恢复期躁动的危险因素(χ^(2)=9.03、4.95、5.84、11.49,均P<0.05)。多因素回归分析结果显示,术前焦虑、术后疼痛、使用拮抗剂是动脉导管未闭患儿介入术后麻醉恢复期躁动的独立危险因素(OR=2.870、4.083、6.975,P=0.029、0.004、0.002,95%CI=1.114~7.389、1.555~10.722、2.052~23.711),术中应用右美托咪啶是动脉导管未闭患儿介入术后麻醉恢复期躁动的保护因素(OR=0.318,P=0.021,95%CI=0.120~0.839)(P<0.05)。结论术中应用右美托咪定、术前焦虑、术后疼痛、使用拮抗剂是动脉导管未闭患儿介入术后麻醉恢复期躁动的独立危险因素,临床医师在治疗时应重视上述因素,在患儿麻醉恢复期进行预防,以减少躁动后发生损伤的风险。Objective To investigate the related factors of restlessness during the anesthesia recovery period in children with patent ductus arteriosus after interventional surgery.Methods The clinical data of 92 pediatric patients with patent ductus arteriosus who underwent cardiac catheterization at Children's Hospital,Zhejiang University School of Medicine from November 2019 to October 2020 were retrospectively analyzed.These patients were divided into two groups based on the occurrence of restlessness during the anesthesia recovery period:a control group(n=67,without restlessness)and an observation group(n=25,with restlessness).Clinical data from both groups were collected and compared.Univariate and multivariate analyses were conducted to identify independent risk factors for restlessness during the anesthesia recovery period among pediatric patients with patent ductus arteriosus after interventional surgery.Results Univariate analysis revealed no statistically significant differences in gender,age,temperament type,surgical duration,resuscitation room stay time,as well as blood pressure,heart rate,and blood oxygen saturation during the anesthesia recovery period between the two groups(all P>0.05).However,the use of dexmedetomidine during surgery,preoperative anxiety,postoperative pain,and the use of antagonists were identified as risk factors for postoperative restlessness among pediatric patients with patent ductus arteriosus after interventional surgery(χ^(2)=9.03,4.95,5.84,11.49,all P<0.05).Multivariate regression analysis results further revealed that preoperative anxiety,postoperative pain,and the use of antagonists were independent risk factors for postoperative restlessness(OR=2.870,4.083,6.975,P=0.029,0.004,0.002,95%CI=1.114-7.389,1.555-10.722,2.052-23.711),while intraoperative use of dexmedetomidine served as a protective factor(OR=0.318,P=0.021,95%CI=0.120-0.839,all P<0.05).Conclusion The intraoperative use of dexmedetomidine,preoperative anxiety,postoperative pain,and the use of antagonists are identified a

关 键 词：动脉导管未闭 儿童 经皮冠状动脉介入治疗 麻醉恢复期 危险因素 右美托咪啶 焦虑 疼痛 

分 类 号：R726.1[医药卫生—儿科]