摘要
目的 探讨分析全麻患者术后苏醒延迟情况及其危险因素.方法 采用随机数字表法抽取2018年6月至2023年6月期间在陆军军医大学第二附属医院、重庆市第九人民医院、重庆市西区医院行全麻手术的患者为研究对象,采用描述分析法分析术后苏醒延迟发生情况,并予logistic回归分析苏醒延迟的危险因素.结果 本研究共纳入1 056例全麻患者,术后在麻醉恢复室(PACU)驻留时间为30～98 min,其中有196例(18.56％)发生苏醒延迟.经logistic回归分析显示,年龄(36～65岁OR=4.541,66～78岁OR=6.413)、心功能等级(Ⅱ级OR=3.685,Ⅲ级OR=5.493)、BMI≥24(kg/m2)(OR=3.466)、低体温(OR=3.173)、术中追加麻醉药物(OR=3.840)、术中补液量较高(OR=3.419)、合并基础疾病(OR=3.120)、麻醉时间较长(OR=2.628)、急诊手术(OR=3.104)、中枢神经系统损伤(OR=3.426)、代谢性疾病(OR=3.769)、呼吸功能障碍(OR=3.276)、有饮酒习惯(OR=2.878)、肾功能异常(OR=3.256)、组织器官血液灌注异常(OR=3.432)、麻醉药物的绝对或相对过量(OR=3.180)的全麻患者术后苏醒延迟发生可能性更高.结论 全麻患者术后苏醒延迟发生率偏高,年龄、BMI较高、低体温、术中补液量较高、术中追加麻醉药物、麻醉时间、急诊手术、中枢神经系统损伤、代谢性疾病、合并基础疾病、心功能等级、呼吸功能障碍、饮酒习惯、肾功能异常、组织器官血液灌注异常、麻醉药物的绝对或相对过量可能是全麻患者术后苏醒延迟的危险因素.
Abstract
Objective To investigate the delayed recovery and its risk factors in patients with general anesthesia.Methods Patients who underwent general anesthesia in the Second Affiliated Hospital of Army Military Medical Univer-sity,Ninth People's Hospital of Chongqing,and Chongqing West Hospital from June 2018 to June 2023 were selected by random number table method.The incidence of delayed recovery after general anesthesia was analyzed by descriptive analy-sis method,and its risk factors were analyzed by logistic regression.Results A total of 1 056 patients under general anes-thesia were included in this study.The duration of stay in the post anesthesia care unit(PACU)after surgery was 30-98 minutes.Among them,196 cases(18.56％)had delayed recovery.Logistic regression analysis revealed that delayed recov-ery after general anesthesia was more likely to occur in patients aged 36-65 years(OR=4.541)and 66-78years(OR=6.413),with cardiac function grade of Ⅱ(OR=3.685)and Ⅲ(OR=5.493),higher BMI values(OR=3.466),hypothermia(OR=3.173),intraoperative additional anesthetic medication(OR=3.840),increased intraoperative fluid vol-ume administered(OR=3.419),complicated with underlying diseases(OR=3.120),longer anesthesia duration(OR=2.628),emergency surgeries(OR=3.104),central nervous system injuries(OR=3.426),metabolic diseases(OR=3.769),respiratory dysfunction(OR=3.276),drinking habits(OR=2.878),abnormal kidney function(OR=3.256),abnormal blood perfusion of tissues and organs(OR=3.432),and absolute or relative overdose of anesthetic drugs(OR=3.180).Conclusions There is a high incidence of delayed recovery in patients with general anesthesia.Age,high BMI,hypother-mia,excessive intraoperative fluid volume administered,intraoperative additional anesthetic medication,duration of anes-thesia,emergency surgery,central nervous system injury,metabolic diseases,complicated with underlying diseases,cardiac function grade,respiratory dysfunction,drinking habits,abnormal kidney function,abnormal blood perfusion of tissues and organs,and absolute or relative overdose of anesthetic drugs are risk factors for delayed recovery after general anesthesia.
基金项目
国家卫生健康委规划全国重点课题(十四五)(YYWS4351)
重庆市荣昌区科学技术项目(荣科发[2017]6号)
NETL
NSTL
万方数据