微创医学

目的观察小儿腹腔镜术后苏醒期低氧血症的发生率及影响因素。方法回顾分析该院1604例小儿腹腔镜术麻醉病例的苏醒期资料,总结低氧血症的发生率及原因。结果呼吸空气下,苏醒期有287例发生低氧血症,发生率为17.89%。其发生时段以拔管后5min内最明显;发生的原因主要是呼吸道梗阻,占70.73%;与3岁以后患儿相比,新生儿、婴幼儿低氧血症发生率较高(P<0.05);PARS评分≤6分的患儿低氧血症发生率明显升高(P<0.01);而术中不同气腹压力、不同气腹时间与苏醒期低氧血症的发生无明显关系(P>0.05)。结论低氧血症仍然是小儿腹腔镜术后苏醒期常见并发症,术后要充分复苏,正确评估呼吸功能,严密观察呼吸指标,保持呼吸道通畅并及时吸氧。

Objective To observe the incidence and risk factors of hypoxemia during recovery period after laparoscopic surgery on children.Methods The recovery period materials of 1 604 cases of children of laparoscopic surgery anesthesia of our hospital were analyzed retrospectively,and the incidence and risk factors of hypoxemia were summarized and analyzed.Results With the inspired air condition,287 cases (17.89%) were occurred hypoxemia during recovery period and most occurred at the time of 5 min after extubation.The main reasons were respiratory tract obstruction (70.73%);the incidence rate in newborn and infants was significantly higher than that of children over 3 years old (P<0.05).Children whose PARS scored ≤6 were more often occurred hypoxemia (P<0.01);pneumoperitoneum pressure and time during surgery did not present significant relation with hypoxemia during recovery period (P>0.05).Conclusion Hypoxemia remains the common complication of children laparoscopic surgery during recovery period. Fully resuscitation,correctly evaluation of respiratory function,rigorously observation of respiratory indexes,airway patency keeping and oxygen inhalation should be taken after surgery.

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