肝脏术后患者全麻苏醒期间躁动高危因素的分析

目的分析肝脏术后患者全麻苏醒期间躁动的高危因素。方法对202例肝脏术后患者转入麻醉恢复室后躁动的发生情况进行详细记录,采用单因素、多因素回归分析的方法寻找影响肝脏术后患者苏醒期躁动发生的高危因素。结果 202例肝脏手术患者全麻苏醒期发生躁动53例,发生率为26.23%。经单因素、Logistic回归分析得出肝脏术后全麻苏醒期患者躁动发生的高危因素为术中应用罗库溴铵和七氟烷、肝门阻断时间长及术前合并肝硬化。结论应加强全麻苏醒室医护人员与麻醉医生和手术医生的交接班,掌握患者术中罗库溴铵和七氟烷等麻醉用药情况、肝门阻断时间及患者术前肝硬化程度。术后根据患者的高危因素评分,及早采取预见性治疗和护理措施,以降低肝脏术后全麻苏醒期间患者躁动的发生率。

Analysis on High Risk Factors of Agitation during Recovery Period of General Anaesthesia in Hepatic Resection Patients

Objective To analyze the high risk factors of agitation during recovery period of general anaes- thesia in hepatic resectin patients. Methods The agitation in 202 patients who were transferred to post an- esthesia care unit（PACU） after hepatic resection were well documented. Single factor and multivariate re- gression analysis were adopted to find the risk factors that affect the emergence agitation in patients with hepatic resection. Results Of 202 patients with liver surgery, agitation occurred in 53 （26.23 %） patients during recovery period of general anaesthesia. Single factor and logistic regression analysis showed the high risk factors of emergence agitation during recovery period of general anaesthesia in hepatic resectin patients inluded intraoperative application of rocuronium and sevoflurane,long-term portal triad clamping and pre- operative liver cirrhosis. Conclusion The shifting relief system should be strengthend for the medical staff of PACU,anesthesia physicians and surgeons. They should also master the use of anaesthetic drugs such as rocuronium and sevoflurane as well as porta hepatis and preoperative liver cirrhosis. Postoperative patients take early predictability of treatment and care measures to reduce the incidence of agitation during recovery period of general anaesthesia in hepatic resectin patients according to the risk factors scores.