全身麻醉眼科手术患儿术后新发低氧血症危险因素分析

Analysis of risk factors for infant hypoxemia after general anesthesia undergoing ophthalmological surgery

目的探讨全身麻醉眼科手术患儿术后新发低氧血症的危险因素。方法回顾分析2015年2月—2020年1月择期行全身麻醉下眼科手术的患儿96例,根据术后SpO_(2)分为正常氧合组(54例)和低氧血症组(42例)。对组间比较差异有统计学意义的变量进行单因素Logistic回归,将单因素分析中P<0.2的因素纳入多因素Logistic回归模型,分析患儿术后低氧血症的危险因素。结果低氧血症组胎龄低于正常氧合组(P<0.05),合并基础疾病、术前哭闹比例高于正常氧合组(P<0.05)。Logistics回归分析显示,低胎龄[比值比(odds ratio,OR)=4.614,95%CI 1.753~12.113,P=0.003]、合并基础疾病(OR=2.405,95%CI 1.105~6.427,P=0.046)、术前哭闹(OR=6.533,95%CI 2.062~20.693,P=0.012)、术中使用阿片类药物(OR=12.947,95%CI 3.286~51.069,P<0.001)是全身麻醉眼科手术患儿术后新发低氧血症的危险因素。结论低胎龄、合并基础疾病、术前哭闹、术中使用阿片类药物是全身麻醉眼科手术患儿术后新发低氧血症的独立危险因素。术前避免患儿哭闹及术中减少阿片类药物使用可减少术后低氧血症的发生。

Objective To investigate the risk factors of neonatal hypoxemia after ophthalmologic surgery under general anesthesia.Methods Based on the value of postoperative oxygen saturation,96 infants who underwent elective ophthalmological surgery under general anesthesia in our hospital from February 2015 to January 2020 were divided into the Nonhypoxemia group(normal oxygenation group,n=54)and the hypoxemia group(hypoxemia group,n=42).Singlefactor Logistic regression was performed on variables with statistical differences between the groups,and variables with P<0.2 in the singlefactor regression were included in the multivariate Logistic regression to explore the related risk factors of factors of hypoxemia in the infants.Results The results of Logistic regression analysis showed that low gestational age[odds ratio(OR)=4.614,95%confidence interval(CI)1.753‒12.113,P=0.003],combined with underlying diseases(OR=2.405,95%CI 1.105‒6.427,P=0.046),crying before surgery(OR=6.533,95%CI 2.062‒20.693,P=0.012)and the use of opioids(OR=12.947,95%CI 3.286‒51.069,P<0.001)were independent risk factors for hypoxemia in infants after general anesthesia undergoing ophthalmological surgery.Conclusions Low gestational age,combined with underlying diseases,crying before surgery,and opioid use were independent risk factors for hypoxemia of infants after general anesthesia.To a certain extent,avoiding crying before surgery and reducing the use of opioids during surgery would lower the incidence of postoperative hypoxemia.