改良电休克治疗术后呼吸暂停恢复时间的影响因素

Influencing factors of apnea time after modified electroconvulsive treatment

目的:探讨改良电休克治疗(MECT)术后呼吸暂停恢复时间的影响因素。方法:对210例有MECT适应证的精神病患者进行MECT治疗,术前收集患者的一般资料、所用抗精神病药种类、张口度、Mallampati气管分级、首次MECT的各项参数、麻醉剂用量以及术后呼吸暂停恢复时间。根据术后呼吸暂停恢复时间划分为:≤5 min组169例和>5 min组41例;分析呼吸暂停恢复时间延长的影响因素,建立多重线性逐步回归模型。结果:多重线性回归分析显示,自变量血红蛋白水平(β=-0.053,t=-7.049;P=0.000)、张口度(β=1.206,t=4.395;P=0.000)、气管分级(β=0.988,t=3.407;P=0.001)及抗精神病药种类(β=0.406,t=3.037;P=0.003)可以解释术后呼吸暂停恢复时间延长的67.4%的变异,该模型的矩阵拟合性较好。结论:MECT术后呼吸暂停恢复时间延长与多种因素有关。

Objective：To explore the influencing factors of apnea time after modified electroconvulsive thera-py（ MECT）. Method：A total of 210 psychotic patients who met the indications of MECT received the MECT.The data of patients′general information,using the types of antipsychotic drugs,mouth opening degree（ MO）,mallampati classification（MMC）,MECT parameters for the first time,the dosage of anesthetic and postoperative recovery time for sleep apnea were collected. All of the patients were divided into two groups according to the apnea time（ less or equal to 5 min and above）after treatment.Multilinear stepwise regression analysis was performed to identify influen-cing factors associated with the prolonged recovered respiratory. Results：Multilinear stepwise regression analysis showed that the following factors were independent variables of the prolonged recovery respiratory after MECT：the level of hemoglobin（β = -0.053,t = -7.049,P =0.000 ）,MO（β =1.206,t =4.395,P =0.000 ）,MMC （β=0.988,t=3.407,P=0.001）,and types of antipsychotics（β=0.406,t=3.037,P=0.003）.These variables can explain 67.4% variations;and the model was appear to be fitting well. Conclusion：Various factors were associated with the prolonged recovered respiratory after MECT.