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中国护理管理 ›› 2023, Vol. 23 ›› Issue (9): 1378-1383.doi: 10.3969/j.issn.1672-1756.2023.09.019

• 护理安全 • 上一篇    下一篇

麻醉后复苏室中儿科患者呼吸道不良事件的风险因素分析

刘爱华 石贇   

  1. 复旦大学附属儿科医院麻醉科,201102 上海市
  • 出版日期:2023-09-15 发布日期:2023-09-15
  • 通讯作者: 石贇,硕士,副主任医师,E-mail:shi_yun@fudan.edu.cn
  • 作者简介:刘爱华,本科,主管护师,护士长

Analysis on risk factors of adverse airway events in pediatric patients after general anesthesia in the Post-Anesthesia Care Unit

LIU Aihua, SHI Yun   

  1. Department of Anesthesiology, Children's Hospital of Fudan University, Shanghai, 201102, China
  • Online:2023-09-15 Published:2023-09-15
  • Contact: E-mail:shi_yun@fudan.edu.cn

摘要: 目的:对麻醉后复苏室中患儿发生呼吸道不良事件的现状及其风险因素进行分析,以期提高患儿护理安全与质量。方法:以从2021年9月1日至2022年8月31日期间全身麻醉后转入麻醉后复苏室的16?012名患儿为研究对象,回顾分析他们在麻醉后复苏室中的呼吸道不良事件发生率与临床表现,通过卡方检验和多因素逻辑回归分析,确定患儿发生呼吸道不良事件的风险因素。结果:患儿呼吸道不良事件的发生率为0.6%(90例),肺不张是最常见的原因,经处理,其中93.3%(84例)的患儿可恢复并且无需提高术后护理级别,6.7%(6例)的患儿无法脱离呼吸机,并意外转入重症监护病房。美国麻醉医师协会分级≥Ⅲ级、年龄≤28天、胸外科手术的患儿发生呼吸道不良事件的概率明显升高,多因素逻辑回归分析显示,后两者是风险因素。结论:儿童在麻醉后复苏室中的呼吸道不良事件发生率较高,对具有呼吸道不良事件高风险的患儿应重点关注。

关键词: 儿童麻醉;麻醉后复苏室;呼吸道不良事件;风险因素;麻醉护理

Abstract: Objective: To investigate the status and risk factors of the adverse airway events in pediatric patients in Post-Anesthesia Care Unit (PACU), and to improve the safety and quality of post anesthesia care. Methods: A retrospective analysis was conducted on the incidence and clinical manifestations of respiratory adverse events in 16 012 children transferred to PACU after general anesthesia from September 1st, 2021 to August 31st, 2022. Chi-Square analysis and multivariate logistic regression analysis were used to find the risk factors of adverse airway events in this population. Results: The overall incidence of airway adverse events was 0.6%, and atelectasis was the most common cause. After treatment, 93.3% of the children could recover without the need to improve the postoperative care level, while 6.7% of the children couldn't wean from ventilation and were unexpectedly transferred to the Intensive Care Unit. The incidence of adverse airway events in children with American Association of Anesthesiologists grade ≥Ⅲ, age ≤28 days, and thoracic surgery was significantly higher. Multivariate logistic regression revealed that the latter two were risk factors. Conclusion: The incidence of adverse airway events in pediatric patients in PACU is relatively high. Special attention should be given to the children with high risks.

Key words: pediatric anesthesia; Post-Anesthesia Care Unit; adverse airway event; risk factor; anesthesia nursing care

中图分类号:  R47;R197