阻塞性睡眠呼吸暂停综合征患儿全麻术后拔管时间的影响因素分析

doi:10.19438/j.cjoms.2023.02.014

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (2): 180-185.doi: 10.19438/j.cjoms.2023.02.014

阻塞性睡眠呼吸暂停综合征患儿全麻术后拔管时间的影响因素分析

施金雅, 李静洁, 刘锦星^*, 仇琳^*

上海交通大学医学院附属第九人民医院麻醉科,上海 200011

收稿日期:2022-11-28 修回日期:2022-12-29 出版日期:2023-03-20 发布日期:2023-06-12
通讯作者: 刘锦星,E-mail: liujinxing323@163.com;仇琳,E-mail: choul1277@sh9hospital.org.cn。^*共同通信作者
作者简介:施金雅（1989-）,女,硕士研究生,E-mail: drsjy0116@163.com

Influencing factors of extubation time after general anesthesia in children with obstructive sleep apnea syndrome

SHI Jin-ya, LI Jing-jie, LIU Jin-xing, QIU Lin

Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine. Shanghai 200011, China

Received:2022-11-28 Revised:2022-12-29 Online:2023-03-20 Published:2023-06-12

摘要/Abstract

摘要： 目的： 探讨行腭咽成形术/扁桃体和（或）腺样体切除术（消融术）等具有阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome, OSAS）表现的患儿全麻术后气管导管拔除时间的影响因素。方法： 选取择期全麻下行腭咽成形术/扁桃体和（或）腺样体切除术(消融术）OSAS患儿529例（ASA分级Ⅰ~Ⅱ级,年龄3~12岁）。将术后拔管时间按从快到慢排列,四分位的前75%定义为“快拔管”,其余25%定义为“慢拔管”。其中术后慢拔管患儿137例,快拔管患儿392例。比较2组患儿的临床资料,采用逐步回归法分析拔管时间的影响因素。采用SPSS 21.0软件包对数据进行统计学分析。结果： 术后躁动、麻醉方式（全凭吸入∶全凭静脉）、芬太尼总量、右美托咪定及新斯的明使用、镇痛泵使用,2组比较有统计学差异（P<0.05）。结论： 术后躁动、麻醉方式、芬太尼总量、右美托咪定及新斯的明使用、镇痛泵使用是行腭咽成形术、扁桃体和（或）腺样体切除术（消融术）患儿全麻术后气管导管拔除时间的独立影响因素。

关键词: 拔管时间, 全身麻醉, 阻塞性睡眠呼吸暂停综合征, 儿童

Abstract: PURPOSE: To investigate the influencing factors of tracheal extubation time after general anesthesia in children with obstructive sleep apnea syndrome(OSAS) who underwent palatopharyngoplasty, tonsillectomy and/or adenoidectomy (ablation). METHODS: A total of 529 children (ASA gradeⅠ-Ⅱ, aged 3-12 years) with OSAS who underwent palatopharyngoplasty/tonsillectomy and/or adenoidectomy(ablation) under general anesthesia were retrospectively analyzed. In the data collected, the first 75% of the quartile was defined as "fast extubation" and the remaining 25% was defined as "slow extubation" in order of extubation time from fast to slow. There were 137 cases with slow extubation after anesthesia, and 392 cases with rapid extubation after anesthesia. The data of the two groups were compared, and the influencing factors of extubation time were analyzed by stepwise regression with SPSS 21.0 software package. RESULTS: There were significant differences between the two groups in emergence agitation, anesthesia method (inhalation anesthesia vs intravenous anesthesia), total amount of fentanyl, use of dexmedetomidine and neostigmine, and use of analgesic pump (P<0.05). CONCLUSIONS: Emergence agitation, anesthesia method, total amount of fentanyl, use of dexmedetomidine and neostigmine, and use of analgesic pump were the influencing factors of tracheal extubation time.

Key words: Extubation time, General anesthesia, Obstructive sleep apnea syndrome, Children

中图分类号:

R782.05

施金雅, 李静洁, 刘锦星, 仇琳. 阻塞性睡眠呼吸暂停综合征患儿全麻术后拔管时间的影响因素分析[J]. 中国口腔颌面外科杂志, 2023, 21(2): 180-185.

SHI Jin-ya, LI Jing-jie, LIU Jin-xing, QIU Lin. Influencing factors of extubation time after general anesthesia in children with obstructive sleep apnea syndrome[J]. China J Oral Maxillofac Surg, 2023, 21(2): 180-185.

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阻塞性睡眠呼吸暂停综合征患儿全麻术后拔管时间的影响因素分析

Influencing factors of extubation time after general anesthesia in children with obstructive sleep apnea syndrome

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