老年肝癌切除术患者全麻术后苏醒延迟的高危因素分析(1)
【摘要】 目的：探討老年肝癌切除术患者全麻术后苏醒延迟的高危因素。方法：回顾性分析2015年4月-2019年3月于笔者所在医院接受肝癌切除术的老年肝癌患者临床资料，患者均行全身麻醉，根据患者苏醒情况，选取13例发生苏醒延迟的患者作为观察组(麻醉苏醒时间≥2 h)，另选取107例未发生苏醒延迟的患者作为对照组(麻醉苏醒时间<2 h)，经Logistic回归分析苏醒延迟的高危因素。结果：两组性别占比比较，差异无统计学意义(P>0.05);观察组年龄≥70岁、身体质量指数(BMI)≥25 kg/m2、美国麻醉医师协会(ASA)分级≥Ⅲ级、合并高血压、合并冠心病、术中体温过低、术中输液量≥3 000 ml、麻醉史、手术时间≥4 h占比高于对照组，差异均有统计学意义(P<0.05);经Logistic回归分析显示，年龄(≥70岁)、BMI(≥25 kg/m2)、ASA分级(≥Ⅲ级)、合并高血压、合并冠心病、术中体温过低、术中输液量(≥3 000 ml)、麻醉史、手术时间(≥4 h)为老年肝癌切除术患者全麻术后苏醒延迟的相关影响因素(OR>1，P<0.05)。结论：年龄≥70岁、BMI≥25 kg/m2、ASA分级≥Ⅲ级、合并高血压及冠心病、术中体温过低、术中输液量≥3 000 ml、麻醉史、手术时间≥4 h均为老年肝癌切除术患者全麻术后苏醒延迟的高危因素，可为临床制定预防性措施提供参考。
【关键词】 肝癌切除术 老年 全身麻醉 苏醒延迟
doi：10.14033/j.cnki.cfmr.2020.22.024 文献标识码 B 文章编号 1674-6805(2020)22-00-03
[Abstract] Objective： To investigate the high risk factors of delayed recovery after general anesthesia in senile patients with hepatectomy for liver cancer. Method： The clinical data of senile liver cancer patients with hepatectomy in the hospital from April 2015 to March 2019 were retrospectively analyzed. All patients underwent general anesthesia. According to the recovery of patients， 13 patients with delayed recovery were selected as observation group (anesthesia recovery time ≥2 h)， and 107 patients without delayed recovery were selected as control group (anesthesia recovery time <2 h). The high risk factors for delayed recovery were analyzed by Logistic regression. Result： There was no statistical difference in the proportion of gender between two groups (P>0.05). The proportion of age ≥70 years old， body mass index (BMI) ≥25 kg/m2， America Society of Anesthesiologist (ASA) grading ≥grade Ⅲ， combined with hypertension， combined with coronary heart disease， intraoperative hypothermia， intraoperative infusion volume ≥3 000 ml， history of anesthesia， operation time ≥4 h in observation group were significant higher than those in the control group (P<0.05). Logistic regression analysis showed that age (≥70 years old)， BMI (≥25 kg/m2)， ASA grading (≥grade Ⅲ)， combined with hypertension， combined with coronary heart disease， intraoperative hypothermia， intraoperative infusion volume (≥3 000 ml)， history of anesthesia， operation time (≥4 h) were related influencing factors for delayed recovery after general anesthesia in senile patients with hepatectomy for liver cancer (OR>1， P<0.05). Conclusion： Age ≥70 years old， BMI ≥25 kg/m2， ASA grading ≥grade Ⅲ， combined with hypertension coronary and heart disease， intraoperative hypothermia， intraoperative infusion volume ≥3 000 ml， history of anesthesia， operation time ≥4 h are the high risk factors for delayed recovery after general anesthesia in senile patients with hepatectomy for liver cancer， which can provide reference for clinical development of preventive measures., 百拇医药(赵建立 韦国温 黄敏坚 黄红梅)
【关键词】 肝癌切除术 老年 全身麻醉 苏醒延迟
doi：10.14033/j.cnki.cfmr.2020.22.024 文献标识码 B 文章编号 1674-6805(2020)22-00-03
[Abstract] Objective： To investigate the high risk factors of delayed recovery after general anesthesia in senile patients with hepatectomy for liver cancer. Method： The clinical data of senile liver cancer patients with hepatectomy in the hospital from April 2015 to March 2019 were retrospectively analyzed. All patients underwent general anesthesia. According to the recovery of patients， 13 patients with delayed recovery were selected as observation group (anesthesia recovery time ≥2 h)， and 107 patients without delayed recovery were selected as control group (anesthesia recovery time <2 h). The high risk factors for delayed recovery were analyzed by Logistic regression. Result： There was no statistical difference in the proportion of gender between two groups (P>0.05). The proportion of age ≥70 years old， body mass index (BMI) ≥25 kg/m2， America Society of Anesthesiologist (ASA) grading ≥grade Ⅲ， combined with hypertension， combined with coronary heart disease， intraoperative hypothermia， intraoperative infusion volume ≥3 000 ml， history of anesthesia， operation time ≥4 h in observation group were significant higher than those in the control group (P<0.05). Logistic regression analysis showed that age (≥70 years old)， BMI (≥25 kg/m2)， ASA grading (≥grade Ⅲ)， combined with hypertension， combined with coronary heart disease， intraoperative hypothermia， intraoperative infusion volume (≥3 000 ml)， history of anesthesia， operation time (≥4 h) were related influencing factors for delayed recovery after general anesthesia in senile patients with hepatectomy for liver cancer (OR>1， P<0.05). Conclusion： Age ≥70 years old， BMI ≥25 kg/m2， ASA grading ≥grade Ⅲ， combined with hypertension coronary and heart disease， intraoperative hypothermia， intraoperative infusion volume ≥3 000 ml， history of anesthesia， operation time ≥4 h are the high risk factors for delayed recovery after general anesthesia in senile patients with hepatectomy for liver cancer， which can provide reference for clinical development of preventive measures., 百拇医药(赵建立 韦国温 黄敏坚 黄红梅)