摘要
[目的]探讨老年肝癌切除术患者全麻术后苏醒延迟的危险因素分析。[方法]选择全麻下老年肝癌切除术患者240例,分析术后苏醒延迟发生情况。采用单因素分析影响全麻下老年肝癌切除术患者术后苏醒延迟相关因素;采用多因素分析影响全麻下老年肝癌切除术患者术后苏醒延迟的危险因素。调查因素包括性别、年龄、体质指数、饮酒史、贫血史、呼吸功能障碍、ASA分级、TNM分期、手术时间、麻醉时间、术中复合硬膜外麻醉、术中输血、术中输液量、低体温、手术方式。[结果]240例中,发生术后苏醒延迟53例(延迟组),发生率为22.08%;未发生术后苏醒延迟187例(无延迟组),发生率为77.92%。经单因素分析结果显示,延迟组与无延迟组患者性别、体质指数、贫血史、ASA分级、手术方式、TNM分期、手术时间、术中复合硬膜外麻醉和术中输血比较差异无统计学意义(P>0.05),2组患者年龄、饮酒史、呼吸功能障碍、麻醉时间、术中输液量和术中低体温比较差异有统计学意义(P<0.05)。将上述单因素分析差异具有统计学意义的纳入多因素分析结果显示:年龄、饮酒史、呼吸功能障碍、麻醉时间、术中输液量和术中低体温为影响全麻下老年肝癌切除术患者术后苏醒延迟的危险因素。[结论]影响全麻下老年肝癌切除术患者术后苏醒延迟的危险因素较多,为加快患者术后苏醒,提高患者生存质量,应针对上述危险因素采取相应的预防措施。
[Objective]To investigate the risk factors of delayed recovery after general anesthesia in elderly patients undergoing hepatectomy for hepatocellular carcinoma.[Methods]The 240 elderly patients undergoing hepatectomy under general anesthesia in our hospital from January 2016 to January 2019 were selected to analyze the occurrence of delayed recovery after operation.Single factor analysis was used to analyze the related factors affecting the delayed awakening of elderly patients undergoing hepatectomy under general anesthesia.Multivariate analysis was used to analyze the risk factors affecting the delayed awakening of elderly patients undergoing hepatectomy under general anesthesia.Investigation factors included sex, age, body mass index, drinking history, anemia history, respiratory dysfunction, ASA classification, TNM stage, operation time, anesthesia time, intraoperative combined epidural anesthesia, intraoperative blood transfusion, intraoperative infusion volume, intraoperative hypothermia.[Results]Among 240 elderly patients undergoing hepatectomy under general anesthesia, 53 patients had delayed awakening, the incidence was 22.08%.Univariate analysis showed that there were no significant differences in gender, body mass index, anemia history, ASA classification, TNM stage, operation time, intraoperative combined epidural anesthesia and intraoperative blood transfusion between the two groups(P>0.05);age, drinking history, respiratory dysfunction, anesthesia time, intraoperative infusion volume and operation between the two groups.There was a significant difference between low and moderate body temperature(P<0.05).The results of multivariate analysis showed that age, drinking history, respiratory dysfunction, anesthesia time, intraoperative infusion volume and intraoperative hypothermia were risk factors for delayed recovery of elderly patients undergoing hepatectomy under general anesthesia.[Conclusion]There are many risk factors affecting the delayed recovery of elderly patients undergoing hepatectomy under general anesthesia.In order to speed up the recovery and improve the quality of life of patients, corresponding preventive measures should be taken against these risk factors.
作者
杨永明
赵文林
李青
王嘉庆
王占成
钱程
YANG Yong-ming;ZHAO Wen-lin;LI Qing;WANG Jia-qing;WANG Zhan-cheng;QIAN Cheng(Emergency Department,Xining Second People's Hospital,810000 Xining,Qinghai,China;Shandong Medical College,276000 Jinan,Shandong,China)
出处
《临床消化病杂志》
CAS
2023年第1期61-65,共5页
Chinese Journal of Clinical Gastroenterology
基金
山东省高等学校科技计划项目(No:J17KB094)。
关键词
肝癌
全麻
切除术
术后苏醒延迟
危险因素
liver cancer
general anesthesia
resection
delayed recovery after surgery
risk factors
