胃肠外科肿瘤患者全麻拔管后呼吸系统不良事件发生现状分析

Status Quo of Respiratory System Adverse Events after the Tracheal Extubation for Patients with Gastrointestinal Tumor During the Anesthesia Recovery Period

目的了解麻醉后监护治疗室(post-anesthesia care unit,PACU)胃肠外科肿瘤患者全麻苏醒期气管导管拔除后呼吸系统不良事件发生现状。方法便利抽样法选取2020年12月至2021年1月某院全身麻醉术后带气管导管入PACU的择期胃肠外科肿瘤患者236例为研究对象,记录各类呼吸系统不良事件的发生时间、持续时间、发生次数和人数。结果本组患者中,120例发生呼吸暂停,101例发生呼吸抑制,68例发生去氧饱和,50例发生低氧血症,5例发生严重缺氧,1例因苏醒延迟导致延迟出室。呼吸抑制患者中,71.66%发生在拔管后3 min内,73.26%持续时间超过1 min;去氧饱和患者中,67.32%发生在拔管后3 min内,47.05%持续时间超过1 min;低氧血症患者中,52.00%发生在拔管后3 min内,42.00%持续时间超过1 min。5例严重缺氧患者此前均发生呼吸抑制、去氧饱和和低氧血症。结论PACU胃肠外科肿瘤患者全身麻醉拔管后呼吸系统不良事件发生率较高,须加强对拔管后患者的呼吸管理。

Objective To explore the status quo of respiratory adverse events after the tracheal extubation in patients with gastrointestinal tumor during the anesthesia recovery period so as to provide evidence for predictive respiratory management.Methods From December 2020 to January 2021,236 patients who underwent gastrointestinal tumor surgery and were admitted to post-anesthesia care unit(PACU)with endotracheal tube after general anesthesia were selected by convenience sampling method.And the information including the occurrence time,duration,frequency and number of patients was recorded.Results Among the 236 patients,120 patients had apnea,101 patients had respiratory depression,68 patients had oxygen desaturation,50 patients had hypoxemia,5 patients had severe hypoxia,and 1 patient had delayed out of the room due to delayed recovery.For patients with respiratory depression,71.66%occurred within 3 minutes after extubation,and 73.26%lasted more than 1 minute.For patients with desaturation,67.32%occurred within 3 minutes after extubation,and 47.05%lasted more than 1 minute.For patients with hypoxemia,52.00%occurred within 3 minutes after extubation,and 42.00%lasted more than 1 minute.All the 5 patients with severe hypoxia used to have respiratory depression,desaturation and hypoxemia.Conclusions The occurrence rate of respiratory adverse events among gastrointestinal tumor patients after the tracheal extubation in PACU is still high.Thus,medical staff should pay more attention to the management of patients after tracheal extubation.