贵州医科大学学报

2016, v.41;No.188(05) 606-609+614

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脑干肿瘤手术围麻醉期不良事件相关因素分析
Analysis of Relevant Factors for Anesthesia Adverse Events during Surgery of Brainstem Tumor

聂颖;唐靖;张建;林涛;
NIE Ying;TANG Jing;ZHANG Jian;LIN Tao;Department of Anesthesiology,Affiliated South Hospital of Southern Medical University;Department of Neurosurgery,Guangdong 999 Brain Hospital;

摘要(Abstract):

目的:探讨脑干肿瘤手术围麻醉期主要不良事件的相关影响因素。方法:收集107例脑干肿瘤手术治疗患者的性别、年龄、术前麻醉医师协会(ASA)分级、病变部位及性质、术前是否合并脑积水或肺炎、手术及麻醉时间、麻醉方式等资料,观察围麻醉期患者心率失常、血压波动、延迟拔管、咳嗽多痰以及术中神经电生理监测(IONM)失败等不良事件发生情况,采用Logistic回归分析对不良事件发生的相关因素进行分析。结果:术前ASA分级、病变性质以及术前合并脑积水是出现循环系统不良事件的危险因素,95%CI分别为1.801~12.350、1.496~7.300及1.009~3.583;术前ASA分级、病变部位以及术前合并肺炎是出现呼吸系统不良事件的危险因素,95%CI分别为1.123~21.825、19.384~370.350及3.036~43.094;全凭静脉麻醉(TIVA)是出现IONM失败的保护因素,95%CI为2.939~21.776。结论:术前ASA分级、病变部位和性质、以及术前是否合并脑积水或肺炎是出现围麻醉期主要不良事件的危险因素,TIVA是出现IONM失败的保护因素。
Objective: To explore the risk factors involved in anesthesia adverse events during surgery of brainstem tumor by Logistic regression. Methods: The clinical data involved in 107 surgical cases of brainstem tumors surgery were collected,including gender,age,preoperative American Society of Anesthesiologists( ASA),the site and category of lesion,hydrocephalus,pneumonia,duration of operation and anesthesia,anesthetic method. The main anesthesia adverse events such as arrhythmia,hemodynamic changes,delayed extubation,cough and phlegmy,failure in intraoperative neurophysiological monitoring( IONM) were observed in perioperative period. These anesthesia adverse events related risk factors were analyzed by Logistic regression analysis. Results: Preoperative ASA,the category of lesion and preoperative complicated hydrocephalus were risk factors for adverse events of circulatory system,and 95% confidence interval( CI) were 1. 801 ~ 12. 350,1. 496 ~ 7. 300,1. 009 ~ 3. 583,respectively. Preoperative ASA,the site of lesion and preoperative complicated pneumonia were risk factors for adverse events in respiratory system,and 95% CI were 1. 123 ~ 21. 825,19. 384 ~370. 350,3. 036 ~ 43. 094,respectively. Total intravenous anesthesia( TIVA) was a protective factor for INOM failure,and 95% CI was 2. 939 ~ 21. 776. Conclusion: Risk factors for anesthesia adverse events are preoperative ASA,the site and category of lesion,and preoperative complicated hydrocephalus or pneumonia. TIVA is a protective factor for IONM failure.

关键词(KeyWords): 脑干肿瘤;外科手术;麻醉;危险因素;Logistic回归分析
brainstem neoplasm;surgery;anesthesia;risk factors;Logistic regression analysis

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作者(Author): 聂颖;唐靖;张建;林涛;
NIE Ying;TANG Jing;ZHANG Jian;LIN Tao;Department of Anesthesiology,Affiliated South Hospital of Southern Medical University;Department of Neurosurgery,Guangdong 999 Brain Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2016.05.030

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