天津医药

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婴幼儿合并轻度上呼吸道感染择期手术全麻的安全性

王义1,2,唐春春1,2,任娟娟1,2,李娟1,2,张超1,2,朱昭琼1,2   

  1. 1. 遵义医学院附属医院麻醉科、贵州省麻醉与器官保护基础研究重点实验室
    2. 遵义医学院附属医院麻醉科、贵州省麻醉与器官保护基础研究重点实验室
  • 收稿日期:2014-03-05 修回日期:2014-07-09 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 朱昭琼

The Feasibility and Security of General Anesthesia for Elective Surgery in Infants with Mild Upper Respiratory Tract Infections

WANG Yi ,TANG Chun chun,REN Juan juan,LI Juan ,ZHANG Chao ,ZHU Zhao qiong   

  1. Department of Anesthesiology, The Affiliated Hospital of Zunyi Medical College
  • Received:2014-03-05 Revised:2014-07-09 Published:2014-11-15 Online:2014-11-15
  • Contact: ZHU Zhao qiong

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摘要：

【摘要】   目的   评估合并轻度上呼吸道感染（URI）的婴幼儿实施全身麻醉的可行性与安全性。 方法   择期手术插管全身麻醉婴幼儿 169 例， 年龄 20 d～ 36 个月 、性别不限、ASA 分级Ⅰ 或Ⅱ 级。 根据术前是否出现上感症状， 将其分为 URI 组（n=41）和非 URI 组（n=128）。 观察并记录患儿一般情况， 手术期、术后呼吸系统相关并发症发生情况。 结果 （1）2 组间比较： 与非 URI 组相比， URI 组在手术期屏气的发生率较高， 咳嗽、多痰、血氧饱和度（SpO2）＜0.95、发热、舌后坠发生率差异无统计学意义， 2 组手术期均无发热。 URI 组术后多痰的发生率较高， 咳嗽、SpO2＜0.95、发热、舌后坠、屏气发生率差异无统计学意义， 2 组在手术期和术后均未发生喉痉挛与支气管痉挛。（2）手术期-术后比较： 与手术期相比， 非 URI 组术后咳嗽、发热的发生率增高， SpO2＜ 0.95、舌后坠的发生率降低； URI 组术后发热的发生率增高， SpO2＜ 0.95、屏气发生率降低， 其余并发症发生率差异无统计学意义。 结论   合并轻度 URI 的婴幼儿在周密的术前评估与谨慎的术中管理下实施气管插管全身麻醉是可行并且相对安全的。

关键词: 上呼吸道感染, 婴儿, 全身麻醉, 围手术期并发症

Abstract:

[Abstract]   Objective   To evaluate the feasibility and security of general anesthesia for elective surgery in infants with
mild upper respiratory tract infections (URI).   Methods   A total of 169 cases of infants underwent general anesthesia for elective surgery, ASAⅠ orⅡ , both sexes, aged 20 days to 36 months, were divided into URI group (n = 41) and non-URI group (n = 128), according to the preoperative symptoms of URI. The general data, the perioperative and postoperative respiratory-related complications were observed and recorded.   Results   (1) There was a higher incidence rate of breath holding during the operation in URI group than that of URI group. There were no significant differences in cough, sputum, blood oxygen saturation (SpO 2) < 0.95, fever, glossoptosis between two groups. No fever was found in both groups. There was a higher incidence rate of sputum after operation in URI group. There were no significant differences in other complications including cough, SpO2 <0.95, fever, glossoptosis and incidence rate of breath holding between two groups. No laryngospasm and bronchospasm were found during operation and after operation in two groups. (2)The incidence of postoperative cough and fever increased, while the incidence rates of SpO2< 0.95 and glossoptosis were lower after operation compared with those during operation in non-URI group.
In URI group, the incidence rate of postoperative fever was higher， and SpO2 < 0.95 and breath holding was lower. There were no significant differences in other complications in URI group.  Conclusion   It is feasible and relatively safe to implement tracheal intubation general anesthesia for the infants with mild URI under thorough preoperative assessment and careful operative management.

Key words: upper respiratory infection, infant, general anesthesia, peroperative complications