上呼吸道感染患儿全身麻醉的安全性研究

Safety of general anesthesia in children with upper respiratory infections

目的探讨上呼吸道感染患儿实施全身麻醉的安全性,为临床治疗提供参考依据。方法选取2013年12月-2014年12月进行手术而需全身麻醉的患儿200例为研究对象,其中术前有上呼吸道感染患儿100例作为感染组,选择同期无上呼吸道感染手术患儿100例作为非感染组,比较两组患儿临床资料,数据采用SPSS 19.0软件进行统计分析。结果两组患儿在麻醉后的平均动脉压(MAP)、血氧饱和度(SpO2)、呼气末二氧化碳分压(PetCO2)、心率等指标比较差异无统计学意义;两组患儿在术中喉痉挛和屏气等并发症的发生均较低,差异无统计学意义,感染组患儿在术中咳嗽、多痰以及发热等并发症的发生率明显高于非感染组(P<0.05);两组患儿在术后喉痉挛和屏气的发生率均为0,感染组患儿在术后咳嗽、多痰、发热等并发症的发生率明显高于非感染组(P<0.05)。结论虽然上呼吸道感染患儿全身麻醉在术中和术后相关并发症发生率较高,但是只要加强术中管理,实施全身麻醉是可行、安全的。

OBJECTIVE To explore the safety of general anesthesia in children with upper respiratory infections so as to provide reference for clinical treatment. METHODS Totally 200 cases of children who required surgery and general anesthesia in Dec. 2013-Dec. 2014 were chosen for the study, of which 100 cases who had upper respiratory infections before surgery were set as the infection group, and another 100 cases of children who had no upper respiratory infections before surgery during the same period were set as the non-infection group. Clinical data were compared between the two groups. The software SPSS 19.0 Was used for statistical analysis. RESULTS The differences were not significant in mean arterial pressure （MAP）, oxygen saturation （SpO2）, end-tidal carbon dioxide partial pressure （PetCO2）, heart rate and other indicators between the two groups of children after anesthesia. The incidences of intraoperative laryngospasm, breath holding and other complications were low in both groups, and the difference was not significant. During the surgery, the incidence of sputum, fever and other complications was significantly higher in the infection group than in the non-infection group （P〈0. 05）. After the surgery, the incidences of postoperative laryngospasm and breath holding were 0 in both groups＇ and the incidence of postoperative cough, sputum, fever and other complications was significantly higher in the infection group than in the non-infection group （P〈0.05）. CONCLUSION Although there is a higher incidence of intraoperative and postoperative complications in children with upper respiratory tract infections undergoing general anesthesia, but as long as the intraoperative management is strengthened, general anesthesia is feasible and safe.