专家指出“围术期并发症定义为术中或术后发生低氧血症、支气管痉挛 .doc

专家指出“围术期并发症定义为术中或术后发生低氧血症、支气管痉挛、喉痉挛、气胸、纵隔气肿、肺不张等”与“术前影像学表现（肺炎、肺气肿、肺不张及纵隔摆动）”中的重叠部分如“肺不张”怎样进行分析”，文中术中或术后出现的各种并发症如肺不张等是指术前并无此种表现，在手术麻醉过程中或者手术后新发的症状。 小儿气道异物取出术围术期并发症的危险因素分析 王丽珺 蔡一榕* 李文献 复旦大学附属眼耳鼻喉科医院麻醉科 【摘要】目的 分析小儿气道异物取出术围术期发生并发症的危险因素。方法 回顾性分析复旦大学附属眼耳鼻喉科医院自2012年3月至2013年3月全麻下行气道异物取出术的7岁以下患儿病史资料，根据病史记录中围术期是否发生并发症分为并发症组和无并发症组。分析两组患儿的性别、年龄、体重、异物类型、异物存留时间、症状、术前影像学表现、异物位置、手术时间以及麻醉方式等，用单因素比较和多因素Logistic回归方法分析各因素与围术期并发症之间的关系。结果 符合入选标准的病史资料共280例，其中31例围术期出现并发症。有/无并发症两组相比，在术前症状、影像学表现和麻醉通气方式上具有统计学差异（P0.05）。Logistic回归分析显示术前影像学表现、麻醉通气方式与小儿气道异物取出术围术期并发症的发生有关，OR值分别为2.045和1.964。结论 术前影像学表现异常和自主呼吸通气方式是小儿气道异物取出术围术期发生并发症的危险因素。 【关键词】 呼吸；异物；支气管镜检查；儿童；危险因素 The risk factors of perioperative adverse events in the removal of airway foreign bodies in children WANG Lijun, CAI Yirong* LI Wenxian Department of Anesthesiology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China. [Abstract] Objective To analyze the risk factors of perioperative adverse events in the removal of airway foreign bodies (FBs) in children. Methods We reviewed the records of all the children within 7 years old who underwent the removal of airway FBs using rigid bronchoscopy between Mar. 2012 and Mar. 2013. We divided these patients into complication group and no complication group according to whether perioperative adverse events occurred. The gender, age, weight, type of FBs, persistence time of FBs, symptoms, preoperative imaging findings, operation time and intraoperative ventilation mode were analyzed. Univariate analysis and multivariate logistic regression analysis were used to examine the relations between perioperative risk factors and the perioperative adverse events. Results There were 280 cases meeting the inclusion criteria, in which 31cases had perioperative adverse events. Symptoms, imaging findings and intraoperative ventilation mode were significantly different between complication group and no complication group（P0.05）. Logistic analysis identified imaging findings and intraoper