儿童耳鼻喉术后谵妄发生现状及影响因素分析

Current status and influencing factors of postoperative delirium in pediatric otolaryngological patients

目的了解耳鼻喉术后患儿谵妄的发生情况,并探讨其影响因素。方法选取2020年2月—5月在浙江省某三级甲等医院行耳鼻喉手术的245例患儿为研究对象,于患儿麻醉苏醒时、返回病房0 min、30 min、60 min时进行疼痛和谵妄评估。收集患儿的一般资料,采用卡方检验、秩和检验和Logistic回归分析术后谵妄的影响因素。结果245例患儿中有39例(15.90%)术后发生谵妄,其中复苏室发生10例(25.64%)、病房发生22例(56.41%)、复苏室及病房均发生7例(17.95%)。Logistic回归显示,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级、术后疼痛是儿童耳鼻喉术后谵妄发生的影响因素。结论儿童耳鼻喉科术后谵妄发生率处于中等水平,ASA分级高、术后疼痛的患儿谵妄发生风险较高。

Objective To explore the current status and influencing factors of postoperative delirium in children after otolaryngological surgery.Methods From February to May 2020,a total of 245 children undergoing otolaryngological surgery in a tertiary first-class hospital in Zhejiang Province were included.Pain and delirium assessment were performed when the child was awakened from anesthesia and at 0,30,and 60 minutes after returning to the ward.Chi-square,rank sum test and logistic regression were used to analyze factors of delirium.Results Postoperative delirium occurred in 39 patients,with an incidence of 15.90%.There were 10 cases(5.64%)occurred in the resuscitation room,22 cases(56.41%)occurred in the ward,and 7 cases(17.95%)occurred both in resuscitation room and ward.Logistic regression showed that the level of American Society of Anesthesiologists(ASA)classification and postoperative pain were the influencing factors of postoperative delirium.Conclusion The incidence of postoperative delirium in pediatric otolaryngological department is moderate.The children with higher ASA classification and postoperative pain may have higher risk of postoperative delirium.