新生儿及婴儿急诊消化道手术围麻醉期风险探讨  

Perianesthetic risks in neonates and infants undergoing emergency gastrointestinal surgery

作　　者：尹红[1] 刘双梅[1] 刘猛 王额尔敦 YIN Hong;LIU Shuangmei;LIU Meng;WANG Eerdun(Department of Anesthesiology,Shengjing Hospital,China Medical University,Shenyang 117004,China)

机构地区：[1]中国医科大学附属盛京医院麻醉科,辽宁沈阳117004 [2]中国人民解放军海军第971医院麻醉科

出　　处：《精准医学杂志》2024年第6期523-526,共4页Journal of Precision Medicine

基　　金：军队卫勤保障能力创新与生成专项计划(21WQ-019)。

摘　　要：目的分析新生儿及婴儿急诊消化道手术麻醉诱导、维持、苏醒期以及术后并发症,为此类麻醉提供参考数据。方法回顾性分析我院196例行急腹症手术的新生儿和婴儿的临床资料,按照患儿年龄分为新生儿组(N组,≤30 d)115例和婴儿组(I组,30 d~6个月龄)81例,收集两组患儿的一般资料、疾病分布、术中及术后并发症发生情况。结果两组体质量(t=-8.517,P<0.05)、低体质量儿比例(χ^(2)=64.909,P<0.05)、早产儿比例(χ^(2)=10.657,P<0.05)、合并先心病比例(χ^(2)=5.210,P<0.05)、合并感染性休克及代谢性酸中毒比例(χ^(2)=8.728,P<0.05)差异具有显著性。N组更易出现麻醉维持阶段低氧血症(χ^(2)=4.123,P<0.05)、低体温(χ^(2)=8.792,P<0.05)以及低血糖(χ^(2)=4.074,P<0.05)。N组术后呼吸支持率(χ^(2)=5.474,P<0.05)、多器官功能衰竭发生率(χ^(2)=5.474,P<0.05)、住院天数(t=4.636,P<0.05)高于I组。结论新生儿及婴儿消化道急诊手术围手术期麻醉相关并发症发生率高,其中新生儿发生低氧血症、低血糖、低体温及呼吸暂停风险明显高于婴儿群体。新生儿急诊外科手术在呼吸道麻醉风险管理中值得重视。Objective To analyze the complications occurring during the induction,maintenance,and recovery phases of anesthesia and the perioperative period in neonates and infants undergoing emergency gastrointestinal surgery.Methods A retrospective analysis was conducted on the clinical data of 196 neonates and infants who underwent surgery for acute abdomen at our hospital.These patients were divided into neonatal group(group N,age≤30 days,115 cases)and infant group(group I,age 30 days to 6 months,81 cases).Data on general information,disease distribution,and intraoperative and postoperative complications were collected for both groups.Results There were significant differences between the two groups in body mass(t=-8.517,P<0.05),proportions of low body mass infants(χ^(2)=64.909,P<0.05)and proportions of premature infants(χ^(2)=10.657,P<0.05),concurrent congenital heart disease(χ^(2)=5.210,P<0.05),and concurrent septic shock and metabolic acidosis(χ^(2)=8.728,P<0.05).Children in group N were more prone to hypoxemia(χ^(2)=4.123,P<0.05),hypothermia(χ^(2)=8.792,P<0.05),and hypoglycemia(χ^(2)=4.074,P<0.05)during the anesthesia maintenance period.In addition,group N exhibited a significantly greater need for respiratory support(χ^(2)=5.474,P<0.05),a significantly higher incidence of multiple organ failure(χ^(2)=5.474,P<0.05),and a significantly extended length of hospital stay(t=4.636,P<0.05)compared with group I.Conclusion The risks associated with perioperative anesthesia are high for neonates and infants undergoing emergency gastrointestinal surgery.Specifically,the risks of hypoxemia,hypoglycemia,hypothermia,and apnea are significantly higher in neonates than in infants.Special attention must be given to the respiratory risks during anesthesia management in neonatal emergency surgery.

关 键 词：消化系统外科手术围 手术期 麻醉 手术中并发症 婴儿 新生 

分 类 号：R726.56[医药卫生—儿科] R722.1[医药卫生—临床医学]