中国口腔颌面外科杂志 ›› 2022, Vol. 20 ›› Issue (2): 164-167.doi: 10.19438/j.cjoms.2022.02.011

• 论著 • 上一篇    下一篇

1 428例口腔颌面外科全麻患者复苏期喉痉挛的相关因素分析

费娟, 杨悦来, 胡崟清   

  1. 上海交通大学医学院附属第九人民医院 手术麻醉科,上海 200011
  • 收稿日期:2021-08-09 修回日期:2021-12-03 出版日期:2022-03-20 发布日期:2022-03-20
  • 通讯作者: 胡崟清,E-mail:qing_0_122@163.com
  • 作者简介:费娟(1988-),女,本科,主管护师,E-mail:sunshine_246@163.com
  • 基金资助:
    上海交通大学医学院护理科研项目(Jyhz2117); 上海交通大学医学院附属第九人民医院护理院级基金(JYHL2020MS06)

Risk factors analysis of laryngospasm among1,428patients with oral, maxillofacial surgery in post-anesthetic care unit

FEI Juan, YANG Yue-lai, HU Yin-qing   

  1. Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2021-08-09 Revised:2021-12-03 Online:2022-03-20 Published:2022-03-20

摘要: 目的:探讨口腔颌面外科患者全麻术后苏醒期间喉痉挛发生的相关风险因素。方法:选择2020年3月—2021年6月上海交通大学医学院附属第九人民医院口腔外科全麻手术后复苏患者1 428例,分为非喉痉挛组及喉痉挛组,分别对患者的一般情况和麻醉手术相关因素进行分析,探讨口腔颌面外科术后患者麻醉复苏期喉痉挛发生率和相关危险因素。采用SPSS 22.O软件包对数据进行统计学分析。结果:1 428例口腔颌面外科术后患者中,男868例,女560例,年龄20~78岁,平均年龄(46.34±11.23)岁。在麻醉复苏期间发生喉痉挛114例,发生率为7.98%。通过Logistic分析,年龄(P=0.002)、吸烟情况(P=0.016)、BMI(P=0.003)、上呼吸道病史(P=0.004)、镇静情况(P=0.006)、复苏期间吸痰次数(P=0.047)与喉痉挛的发生有显著相关性。结论:高龄、吸烟、肥胖、上呼吸道病史、镇静不足、多次吸痰是口腔颌面外科全麻患者麻醉恢复期喉痉挛发生的危险因素。麻醉医护人员应加强喉痉挛发生的预警意识,掌握患者发生紧急喉痉挛的临床表现、诊断要点、观察指标和预防应对措施,减少喉痉挛的发生,从而提高口腔颌面外科患者围麻醉期的安全性。

关键词: 口腔颌面外科, 喉痉挛, 复苏期管理, 相关因素分析

Abstract: PURPOSE: To explore the risk factors of laryngospasm among patients with oral and maxillofacial surgery in post-anesthetic care unit. METHODS: From March 2020 to June 2021, 1 428 patients undergoing oral and maxillofacial surgery in PACU were recruited. Socio-demographic and surgical-anesthesia related characteristics of participates were evaluated and the patients were divided into non-laryngospasm group and laryngospasm group. SPSS 22.0 software package was used to analyze risk factors of laryngospasm among patients. RESULTS: A total of 1 428 patients after oral and maxillofacial surgery were selected in this study, including 868 males and 560 females, aged 20-78 years, with an average age of (46.34±11.23) years. There were 114 patients with laryngospasm in post-anesthetic care unit, and the incidence rate was 7.98%. Logistic analysis showed that age (P=0.002), smoking (P=0.016), BMI(P=0.003), history of upper respiratory tract (P=0.004), Ramsay sedation(P=0.006) and times of sputum suction (P=0.047) in post-anesthetic care unit were the risk factors of laryngospasm. CONCLUSIONS: Old age, smoking, obesity, history of upper respiratory tract, lack of sedation and repeated sputum suction were the risk factors of laryngospasm in patients with oral and maxillofacial surgery in post-anesthetic care unit. Anesthesia care providers should strengthen the awareness of early warning of laryngospasm, promote the observation and preventive measures of laryngospasm, so as to improve the safety of patients during perioperative anesthesia.

Key words: Oral and maxillofacial surgery, Laryngospasm, Post-anesthetic care unit management, Risk factors

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