手术方法对施择期腭成形术小儿手术后早期低氧血症的影响

目的评价不同手术方法对施择期腭成形术小儿手术后早期低氧血症的影响。方法选择321例美国麻醉医师协会(ASA)I级、年龄8个月～14岁拟行腭成形术的患儿,根据不同手术方法将其分为3组。所有患儿采用静吸复合全身麻醉。手术后到达恢复窒即刻(0min)和5、10、15、20、30、40、50、60、120和180min时,记录患儿呼吸空气时的Sp(O2)。结果患儿接受的腭成形术越复杂,其在手术后早期的Sp(O2)水平越低、Sp(O2)的恢复越慢和低氧血症发生率越高。手术后早期的Sp(O2)水平和低氧血症发生率在3组间具有显著差异。结论腭成形术患儿手术后早期Sp(O2)降低严重程度和低氧血症发生率与手术方法密切相关。患儿到达恢复室时的Sp(O2)水平和低氧血症发生率与麻醉恢复评分密切相关,说明术后呼吸功能的恢复取决于麻醉恢复程度。

Influence of Surgical Techniques on Early Postoperative Hypoxemia in Children Undergoing Elective Palatoplasty

Objective To assess the influence of different surgical procedures on early postoperative hypoxemia in children undergoing elective palatoplasty. Methods Three hundred and twelve infants and children, American Society of Anesthesiologists (ASA) grade 1 , aged 8 months to 14 years old, undergoing elective palatoplasty were included in this sludy. According to the surgical procedures, patients were divided into three groups. Combined intravenous - inhalation anesthesia was used in all the patients. Arterial oxygen saturation[Sp(O2)]was recorded while patients were breathing air shortly after arrival in the recovery room (0 min) ,5,10,15,20, 30,40,50,60,120 and 180 min thereafter. Results Patients who underwent more complex surgical techniques for palatoplasty had lower postoperative Sp(O2) values, slower recovery of Sp(O2) ,and a higher incidence of hypoxemia during the early postoperative period. There were significant differences in postoperative Sp(O2) values and incidence of hypoxemia among the three groups. Conclusions The severity of arterial desaturation and incidence of hypoxemia during the early postoperative period are closely related to the surgical procedures. There are significant associations between Sp(O2) values, incidence of hypoxemia on admission to the recovery room and recovery scores, indicating that postoperative recovery of respiratory function may depend on the degree of recovery from anesthesia.