全麻术后患者苏醒期呼吸抑制发生情况及影响因素分析  

Analysis of the occurrence and influencing factors of respiratory depression in patients after general anesthesia during the recovery period

作　　者：卓洁 兰星[1] 袁璐 陈庆红[1] ZHUO Jie;LAN Xing;YUAN Lu;CHEN Qinghong(Department of Anesthesiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,湖北武汉430000

出　　处：《麻醉安全与质控》2025年第1期41-46,共6页Perioperative Safety and Quality Assurance

基　　金：湖北省自然科学基金(一般面上项目:2023AFB952);华中科技大学同济医学院第一临床学院教学研究立项基金(2023XH025)。

摘　　要：目的调查全麻术后患者苏醒期呼吸抑制发生率,并分析相关影响因素,为保障全麻术后患者围术期呼吸道安全提供参考。方法选取2024年3月1日~3月31日华中科技大学同济医学院附属协和医院医院麻醉恢复室(PACU)收治的全麻术后苏醒期患者1630例,根据患者术后苏醒期是否发生呼吸抑制分为呼吸抑制组(n=139)和非呼吸抑制组(n=1491),记录患者临床资料(性别、年龄、BMI、有无肺部疾病、手术时长、手术级别、手术部位、ASA分级)、拔管即刻(给氧状况、肌松拮抗剂使用状况、拔管时长)、拔管后(NRS评分、复苏时长)等因素,采用Logistic回归分析全麻术后患者苏醒期呼吸抑制发生的影响因素。结果全麻术后患者苏醒期呼吸抑制发生率为8.53%(139/1630)。女性(OR=2.789,P=0.000)、拔除气管导管后未给氧气(OR=2.274,P=0.026)、未使用肌松拮抗剂(OR=2.236,P=0.000)为苏醒期患者呼吸抑制发生的独立危险因素,拔管时长越短患者呼吸抑制发生率越高。结论全麻术后患者苏醒期呼吸抑制发生率较高,医护人员应针对危险因素早期识别预警,采取适当措施,避免发生苏醒期呼吸抑制,保障患者苏醒期医疗安全。Objective To investigate the incidence of respiratory depression during the recovery period in patients after general anesthe⁃sia and analyze the relevant influencing factors and to provide reference for ensuring the perioperative respiratory safety of patients after general anesthesia.Methods A total of 1630 patients in the postoperative recovery period of general anesthesia admitted to the post⁃anesthesia recovery unit(PACU)of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from March 1,2024 to March 31,2024 were selected.They were divided into a respiratory depression group(n=139)and a non⁃respiratory depression group(n=1491)according to whether respiratory depression occurred during the postoperative recovery period.The clinical data of patients(gender,age,BMI,presence of lung disease,surgical duration,surgical grade,surgical site,ASA grading),immediate extuba⁃tion(oxygen status,use of muscle relaxant antagonists,extubation duration),and post extubation(NRS score,resuscitation duration)were recorded.Logistic regression analysis was used to investigate the influencing factors of respiratory depression during the postoperative recovery period of general anesthesia patients.Results The incidence of respiratory depression during the recovery period of patients after general anesthesia was 8.53%(139/1630).Female(OR=2.789,P=0.000),failure to administer oxygen after extubation of the endotracheal tube(OR=2.274,P=0.026),and failure to use muscle relaxant antagonists(OR=2.236,P=0.000)are independent risk factors for respiratory depression in patients during the recovery period.The shorter the extubation time,the higher the incidence of respiratory depression in patients.Conclusion The incidence of respiratory depression during the recovery period is high in patients after general anesthesia,and medical staff should identify the risk factors early and take appropriate measures to avoid the occurrence of respira⁃tory depression during the recovery period and ensure the medic

关 键 词：围术期护理 麻醉复苏 呼吸抑制 

分 类 号：R61[医药卫生—外科学]