颈动脉狭窄行内膜剥脱术患者麻醉恢复期常见并发症

Common complications in the postanesthesia care unit in patients with carotid stenosis after carotid endo-arterectomy

目的总结颈动脉狭窄患者施行内膜剥脱术后麻醉恢复期常见并发症的发生情况。方法对2009年3月至2016年6月首都医科大学附属北京天坛医院神经外科颈动脉狭窄施行内膜剥脱手术的患者麻醉恢复期并发症发生情况进行回顾性分析。结果 410例颈动脉狭窄行内膜剥脱手术的患者恢复室的平均观察时间和苏醒时间分别为2 h和15 min。总并发症发生率为70.7%,常见并发症包括高血压(227例,55.4%)、心律失常(107例,26.1%)、苏醒期躁动(36例,8.8%)、手术后恶心呕吐(11例,2.7%)、低氧血症(10例,2.4%)、呼吸道梗阻(9例,2.2%)、低血压(8例,2%)、苏醒延迟(2例,0.5%)、寒战(2例,0.5%)、疼痛(1例,0.2%)。患者转出恢复室时改良Aldrete评分:≥9分者397例,占比为96.8%、≤8分者13例,占比3.2%。结论施行内膜剥脱手术的颈动脉狭窄患者麻醉恢复期应密切监测循环系统,保持血流动力学稳定,减少并发症的发生。

Objective To investigate the postoperative complications after carotid endo-arterectomy during the anesthesia recovery period. Methods The clinical data of 410 patients after carotid endo-arterectomy in PACU from March2009 to June 2016 were analyzed retrospectively. Results The mean monitor duration and recovery time in PACU was 2 hours and 15 min, respectively. 70.7% of 410 patients suffered from post-anesthesia complications during PACU. The complications were hypertension（55.4%）, arrhythmia（26.1%）, emergence agitation（8.8%）, postoperative nausea and vomiting（2.7%）, hypoxemia（2.4%）, respiratory obstruction（2.2%）, hypotension（2%）, delayed emergence（0.5%）, shivering（0.5%） and pain（0.2%）, respectively. Discharge modified Aldrete scores were ≥9 scores in 397 cases（96.8%） and ≤8 scores in 13 cases（3.2%）. Conclusion There are obvious changes in hemodynamics in carotid stenosis patients after carotid endo-arterectomy. Targeted prevention and measures are taken with satisfactory results and reduce the risk of postoperative complications.