中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2025, Vol. 23 ›› Issue (4): 390-394.doi: 10.19438/j.cjoms.2025.04.012

• 论著 • 上一篇    下一篇

口腔颌面外科手术患者全麻复苏期低氧血症的影响因素分析

胡崟清1,*, 王圆2,*, 谭耘1, 费娟1#, 王烨2#   

  1. 1.上海交通大学医学院附属第九人民医院 护理部,2.麻醉科,上海 200011
  • 收稿日期:2025-03-31 修回日期:2025-04-28 出版日期:2025-07-20 发布日期:2025-08-04
  • 通讯作者: 费娟, E-mail: sunshine_246@163.com;王烨,E-mail: wangye31035023@163.com。#共同通信作者
  • 作者简介:胡崟清（1987-）,女,硕士,E-mail: qing_0_122@163.com;王圆（1984-）,女,硕士,E-mail: wangyuanmazk@163.com。*并列第一作者
  • 基金资助:
    上海交通大学医学院附属第九人民医院护理院级基金（JYHL2023MS18）;上海交通大学医学院护理学科建设项目（NX2022qn）

Influencing factors of hypoxemia during general anesthesia recovery after oral and maxillofacial surgery

Hu Yinqing1, Wang Yuan2, Tan Yun1, Fei Juan1, Wang Ye2   

  1. 1. Department of Nursing, 2. Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2025-03-31 Revised:2025-04-28 Online:2025-07-20 Published:2025-08-04

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摘要： 目的：探讨口腔颌面外科手术患者麻醉复苏期低氧血症的影响因素。方法：采用回顾性队列研究设计,纳入2024年1月—2024年12月于上海交通大学医学院附属第九人民医院麻醉后复苏室接受监护的口腔颌面外科手术患者1 417例。依据麻醉复苏期低氧血症发生情况,分为低氧血症组（n=61,SpO2<90%或PaO2<60 mmHg）与正常对照组（n=1 356）。通过单因素方差分析和多因素logistic回归模型,筛选麻醉复苏期低氧血症的独立预测因子,并构建风险预警指标体系。结果：总体低氧血症发生率为4.30%（61/1417）。多因素分析显示,ASA分级≥Ⅲ级(OR=6.61, 95%CI: 4.12~10.58)、合并阻塞性睡眠呼吸暂停（OSA） (OR=5.93, 95%CI: 3.82~9.17)及术后气道吸引频次≥3次(OR=3.35, 95%CI: 2.24~5.01)为口腔颌面外科手术患者麻醉复苏期低氧血症的独立危险因素。结论：口腔颌面外科手术患者麻醉复苏期低氧血症的发生与ASA分级、OSA共病状态及气道管理操作显著相关。建议实施基于风险分层的多模式复苏方案,优化围术期呼吸功能监测,并制定个体化气道管理护理策略。

关键词: 口腔颌面外科手术, 低氧血症, 麻醉复苏期, 护理干预策略, 影响因素

Abstract: PURPOSE: To explore the influencing factors of hypoxemia during the anesthesia recovery period in patients undergoing oral and maxillofacial surgery. METHODS: A retrospective cohort study design was adopted. A total of 1 417 patients undergoing oral and maxillofacial surgery who were monitored in the post-anesthetic care unit of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2024 to December 2024 were included. According to the occurrence of hypoxemia during the anesthesia recovery period, they were divided into the hypoxemia group(n=61, SpO2 < 90% or PaO2 < 60 mmHg) and the normal control group (n=1 356). Univariate analysis of variance and multivariate logistic regression models were used to screen the independent predictors of hypoxemia during the anesthesia recovery period, and a risk warning index system was constructed. RESULTS: The overall incidence of hypoxemia was 4.30% (61/1 417). Multivariate analysis revealed that ASA classification ≥Ⅲ(OR=6.61, 95%CI: 4.12-10.58), comorbid obstructive sleep apnea (OSA) (OR=5.93, 95%CI: 3.82-9.17), and ≥3 postoperative airway suction episodes (OR=3.35, 95%CI: 2.24-5.01) served as independent risk factors. CONCLUSIONS: The occurrence of hypoxemia during the anesthesia recovery period in patients undergoing oral and maxillofacial surgery is significantly associated with ASA classification, coexisting OSA status, and airway management operations. It is recommended to implement a multimodal recovery plan based on risk stratification, optimize perioperative respiratory function monitoring, and formulate individualized airway management nursing strategies.

Key words: Oral and maxillofacial surgery, Postoperative hypoxemia, Anesthesia recovery period, Nursing strategies, Influence factors

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