小儿全身麻醉术后低氧血症危险因素调查与分析

Investigation and analysis of risk factors for hypoxemia after general anesthesia surgery in children

目的:探讨小儿全身麻醉术后低氧血症的危险因素,为降低小儿全身麻醉术后低氧血症的风险提供参考价值。方法:选取全身麻醉术后患儿106例作为研究对象,根据患儿术后的血氧饱和度分为非低氧血症组(53例)和低氧血症组(53例),对有统计学意义的变量进行单因素回归分析,将单因素中P<0.2的因素纳入到多因素回归分析中。结果:非低氧血症组患儿胎龄高于低氧血症组(P<0.05),低氧血症组患儿合并基础疾病、术前哭闹比例高于非低氧血症组(P<0.05)。多因素回归分析显示,影响患儿术后低氧血症的因素是低胎龄[OR=5.153,95%CI(2.597,10.297),P=0.001]、合并基础疾病[OR=2.815,95%CI(1.572,6.253)],P=0.034)、术前哭闹[OR=6.194,95%CI(2.121,13.675),P=0.001)]、使用阿片类药物[OR=7.173,95%CI(2.674,21.193),P=0.001)]。结论:小儿全身麻醉术后患儿发生低氧血症的因素有低胎龄、合并基础疾病、术前哭闹、使用阿片类药物,应针对危险因素给予护理。

Objective:To explore the risk factors of hypoxemia after general anesthesia in children and provide reference value for reducing the risk of hypoxemia.Methods:A total of 106 children after general anesthesia were selected as the research subjects and divided into a non-hypoxemia group(53 cases)and a hypoxemia group(53 cases)according to their postoperative blood oxygen saturation.Single-factor regression analysis was performed on statistically significant variables,and factors with P<0.2 in single factors were included in multi-factor regression analysis.Results:The gestational age of the children in the non-hypoxemia group was higher than that of the hypoxemia group(P<0.05).The children in the hypoxemia group had underlying diseases,and the proportion of crying before surgery was higher than that of the normal oxygenation group(P<0.05).Multivariate regression analysis showed that the factors affecting postoperative hypoxemia in children were low gestational age[odds ratio(OR)=5.153,95%CI(2.597,10.297),P=0.001],combined underlying diseases[OR=2.815,95%CI(1.572,6.253),P=0.034],crying before surgery[OR=6.194,95%CI(2.121,13.675),P=0.001],and use of opioids[OR=7.173,95%CI(2.674,21.193),P=0.001].Conclusions:The factors causing hypoxemia in children after general anesthesia surgery include low gestational age,underlying diseases,crying before surgery and use of opioids.