文章摘要
胸科手术后非计划二次插管的危险因素
Risk factors for unplanned re-intubation after thoracic surgery
  
DOI：10.12089/jca.2020.08.003
中文关键词: 二次插管  胸科手术  拔管  全身麻醉  危险因素
英文关键词: Re-intubation  Thoracic surgery  Extubation  General anesthesia  Risk factors
基金项目:
作者单位E-mail
陈思 100730,中国医学科学院北京协和医学院北京协和医院麻醉科  
张越伦 100730,中国医学科学院北京协和医学院北京协和医院医学科学研究中心  
车璐 100730,中国医学科学院北京协和医学院北京协和医院麻醉科  
申乐 100730,中国医学科学院北京协和医学院北京协和医院麻醉科 pumchshenle@aliyun.com 
黄宇光 100730,中国医学科学院北京协和医学院北京协和医院麻醉科  
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中文摘要:
      
目的 分析和探讨胸科手术后患者接受非计划二次插管的危险因素。
方法 本研究为病例-对照研究。将2014—2018年北京协和医院所有胸科手术后因气道原因接受非计划二次插管的患者与对照组患者进行1∶4配对。采用单因素和多因素分析的方法评估非计划二次插管的危险因素及预后情况。
结果 5年间共完成全麻下胸科手术7 711例，其中12例（0.16%）因气道原因接受了术后非计划二次插管。选择48例患者为对照组。Logistic多因素回归分析显示，年龄≥65岁（OR=22.81，95%CI 1.41~367.97，P=0.028）、麻醉时间每延长10 min（OR=1.24，95% CI 1.07~1.43，P=0.003）、纵隔手术（OR=79.16，95%CI 2.95~2122.85，P=0.009）和术前SpO2＜95%（OR=92.28，95%CI 1.17~7311.58，P=0.043）是造成胸科手术后非计划二次插管的独立危险因素。
结论 年龄≥65岁、麻醉时间延长、纵隔手术、术前SpO2＜95%为胸科手术的患者术后非计划二次插管的危险因素。
英文摘要:
      
Objective To identify the risk factors for patients receiving unplanned re-intubation after thoracic surgery.
Methods This was a case-control study. All the acute airway compromise caused thoracic re-intubation cases in Peking Union Medical College (PUMC) Hospital between 1 Jan, 2014 and 31 Dec, 2018 were compared at the ratio of 1∶4 with controls. The risk factors were further assessed using univariate and Logistic multivariate analysis.
Results There were 7 711 thoracic surgery cases under general anesthesia completed. Among them, 12 cases (0.16%) received unplanned re-intubation due to acute airway compromise. Then 48 patients were selected as control group. Logistic multivariate analysis revealed that age ≥ 65 years (OR = 22.81,95%CI 1.41-367.97, P = 0.028), anesthesia duration (OR = 1.24, 95%CI 1.07-1.43, P = 0.003), mediastinal surgery (OR = 79.16, 95%CI 2.95-2122.85, P = 0.009) and preoperative SpO2<95% (OR = 92.28, 95%CI 1.17-7311.58, P = 0.043) were independent risk factors for patients receiving unplanned re-intubation after thoracic surgery.
Conclusion During the five years, in PUMC hospital, age ≥ 65 years, anesthesia duration, mediastinal surgery, preoperative SpO2<95% are risk factors for patients receiving unplanned re-intubation after thoracic surgery.
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