协和医学杂志

2020, (06) 715-719

[打印本页] [关闭]
本期目录(Current Issue) | 过刊浏览(Past Issue) | 高级检索(Advanced Search)

头颈部手术后非计划二次插管危险因素分析
Risk Factors for Unplanned Reintubation after Head and Neck Surgery

陈思;张越伦;车璐;申乐;黄宇光;
CHEN Si;ZHANG Yue-lun;CHE Lu;SHEN Le;HUANG Yu-guang;Department of Anesthesiology, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Medical Research Center, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

摘要(Abstract):

目的探讨头颈部手术后非计划二次插管的危险因素。方法回顾性分析2014年1月1日至2018年12月31日于北京协和医院行头颈部手术患者的临床资料。以术后非计划二次插管患者为研究组,随机抽取一定量的成功拔管者为对照组,研究组与对照组患者比例为1∶4。多因素Logistic回归分析头颈部手术后非计划二次插管的危险因素。结果共60例(研究组12例,对照组48例)符合纳入和排除标准的患者入选本研究。多因素Logistic回归分析结果显示,有全身麻醉史(OR=9.17, 95%CI:1.05~83.33,P=0.045)、Cormack-Lehane分级Ⅲ级(OR=18.87, 95%CI:1.53~250.00,P=0.022)、术中液体负荷≥20 mL/kg(OR=27.78, 95%CI:1.94~500.00,P=0.014)是头颈部手术后非计划二次插管的危险因素。研究组术后住院时间[7(3.0,17.0)d比2(2.0,5.0)d,P=0.013]、ICU停留时间[1(0.0,2.8)d比0(0.0,0.0)d,P<0.001]均长于对照组。结论头颈部手术后非计划二次插管与有/无全身麻醉史、Cormack-Lehane分级及术中液体负荷有关,其发生不利于患者术后康复。
Objective This study aimed to identify the risk factors for unplanned reintubation after head and neck surgery. Methods This study retrospectively investigated cases that received head and neck surgery in Peking Union Medical College Hospital from January 1, 2014 to December 31, 2018. Patients who received unplanned reintubation after head and neck surgery were enrolled in the study group. Patients who extubated successfully were randomly sampled for the control group. The proportion of patients in the study group and the control group was 1∶4. Multivariable Logistic regression analysis was used to assess the risk factors for unplanned reintubation after head and neck surgery.Results A total of 60 eligible cases(12 cases of the study group, 48 cases of the control group) meeting the inclusive and exclusive criteria were included in this study. Multivariable Logistic regression analysis revealed that general anesthesia history(OR=9.17, 95% CI: 1.05-83.33, P=0.045), Cormack-Lehane grading Ⅲ(OR=18.87,95% CI: 1.53-250.00,P=0.022), and intraoperative fluid load ≥20 mL/kg(OR=27.78,95% CI: 1.94-500.00,P=0.014) were risk factors for unplanned reintubation after head and neck surgery. Compared with the control group, postoperativehospital stay time[7(3.0, 17.0)d vs. 2(2.0, 5.0)d, P=0.013] and ICU stay time[1(0.0, 2.8)d vs. 0(0.0, 0.0)d, P<0.001] of the study group were prolonged significantly.ConclusionsUnplanned reintubation after head and neck surgery is associated with general anesthesia history, Cormack-Lehane grading, and intraoperative fluid load. It acts as a negative factor for patients' rehabilitation.

关键词(KeyWords): 头颈部手术;非计划二次插管;气道管理;全身麻醉
head and neck surgery;unplanned reintubation;airway;general anesthesia

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈思;张越伦;车璐;申乐;黄宇光;
CHEN Si;ZHANG Yue-lun;CHE Lu;SHEN Le;HUANG Yu-guang;Department of Anesthesiology, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Medical Research Center, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

Email:

DOI:

参考文献(References):

扩展功能
本文信息
服务与反馈
本文关键词相关文章
本文作者相关文章
中国知网
分享