腹腔镜胃袖状切除术麻醉恢复期停留时间延长的相关因素初探

Preliminary Analysis on Relevant Factors of Prolonged Observation Time During the Recovery Period After Laparoscopic Sleeve Gastrectomy in Obese Patients

目的 探讨减重患者行腹腔镜胃袖状切除术麻醉恢复期停留时间延长的相关因素。方法 对2015年1月~2022年10月我院88例拟行腹腔镜胃袖状切除术患者的临床资料进行回顾性分析,根据病例纳入、排除标准,共纳入80例,根据术毕拔除气管导管后麻醉恢复期停留时间是否延长分为2组:延长组(n=27)与对照组(n=53)。单因素分析2组年龄、性别、ASA分级、BMI、肥胖患者手术死亡风险评分(Obesity Surgery Mortality Risk Score, OS-MRS)、术前合并症、术中监测情况、出血量、输液量、手术时间、追加镇痛药物、低氧血症及恶心呕吐等方面的差异,有差异的变量进行logistic回归分析。结果单因素分析显示BMI、ASA分级、合并阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome, OSAS)、OS-MRS、拔管后发生低氧血症有统计学差异(P<0.05)。logistic回归分析显示BMI(OR=1.216,95%CI:1.079~1.371,P=0.001)和拔管后发生低氧血症(OR=6.607,95%CI:1.284~34.001,P=0.002)是独立相关因素。结论 BMI与拔除气管导管后发生低氧血症是导致减重患者行腹腔镜胃袖状切除术拔管后麻醉恢复期停留时间延长的独立相关因素。

Objective To study relevant factors of prolonged observation time during the recovery period after laparoscopic sleeve gastrectomy in obese patients. Methods A retrospective analysis was made on 88 cases of laparoscopic sleeve gastrectomy in our hospital from January 2015 to October 22. According to the inclusion and exclusion criteria of cases, a total of 80 cases were included. The patients were divided into two groups according to whether the observation time after tracheal intubation was extended: the extended group(n=27) and the control group(n=53). Univariate analysis of the differences between the two groups in age, sex, ASA grade, BMI, score of Obesity Surgery Mortality Risk Score(OS-MRS), preoperative accompanying diseases, intraoperative monitoring, bleeding volume, infusion volume, operation time, additional analgesics, hypoxemia, and nausea and vomiting was performed. The variables with significant differences were analyzed by the logistic regression. Results Univariate analysis showed that there were significant differences in BMI, ASA grade, obstructive sleep apnea syndrome(OSAS), OSMRS score and hypoxemia after extubation(P<0.05). Logistic regression analysis showed that BMI(OR=1.216, 95% CI: 1.079-1.371, P=0.001) and the incidence of hypoxemia(OR=6.607, 95% CI: 1.284-34.001, P=0.002) were independent relevant factors. Conclusion BMI and hypoxemia are independent relevant factors for extended observation period after extubation in patients undergoing bariatric surgery.