摘要
目的分析影响椎管内麻醉后寒战的多因素及临床治疗手段。方法选择我院在2018年12月至2020年1月期间收治的200例进行椎管内麻醉治疗的患者作为研究对象,以其有无发生寒战作为分组原则,将其分为寒战组(n=47)和非寒战组(n=153)。对非寒战组和寒战组患者的年龄、性别、麻醉方式、术中出血量以及手术时间进行比较,通过多因素Logistic回归分析患者麻醉后发生寒战的影响因素。并且将寒战组患者随机分为两组,一组为参照组(n=25),另一组为观察组(n=22)。参照组和观察组治疗药物分别为布托啡诺和盐酸曲马多,比较两组患者的治疗效果。结果在年龄方面,年龄为(32.18±11.63)岁的青壮年患者其寒战发生率要高于年龄较大的患者(P<0.05);在性别方面,男性患者寒战发生率要高于女性患者(P<0.05);在手术时间方面,寒战发生会随着患者手术时间的延长而增高(P<0.05);在术中出血量方面,寒战发生会随着患者术中出血量的增加而增高(P<0.05);在麻醉方式方面,硬膜外麻醉寒战发生率要低于腰麻以及硬-腰联合麻醉(P<0.05)。多因素Logistic回归分析结果显示青壮年、男性、手术时间过长、术中出血量多、腰麻、硬-腰联合麻醉均为患者麻醉后发生寒战的独立危险因子(P<0.05)。观察组治疗显效率显著高于参照组(P<0.05),但是组间有效率、无效率以及总有效率比较,差异无统计学意义(P>0.05)。结论对于椎管内麻醉患者,其术后发生寒战的影响因素较多,其中年龄、性别、手术时间、术中出血量以及麻醉方式均为发生寒战的其独立影响因素,布托啡诺以及盐酸曲马多均可以对寒战患者起到较为理想的治疗效果。
Objective To analyze the multiple factors and clinical treatment of shivering after intraspinal anesthesia.Methods A total of 200 patients who were treated with intraspinal anesthesia in our hospital from December 2018 to January 2020 were selected as the subjects.According to the principle of whether they had shivering or not,they were divided into shivering group(n=47)and non-shivering group(n=153).The age,sex,mode of anesthesia,intraoperative blood loss and operation time of patients in non-shivering group and cold war group were compared,and the influencing factors of shivering after anesthesia were analyzed by multivariate Logistic regression.The patients in the cold war group were randomly divided into two groups:control group(n=25)and observation group(n=22).The treatment drugs of the control group and the observation group were butorphanol and tramadol hydrochloride respectively,and the therapeutic effects of the two groups were compared.Results In terms of age,the incidence of shivering in young and middle-aged patients with age(32.18±11.63)was higher than that in older patients(P<0.05),and in terms of gender,the incidence of shivering in male patients was higher than that in female patients(P<0.05).In terms of operation time,the incidence of shivering increased with the prolongation of operation time(P<0.05).In terms of intraoperative blood loss,the incidence of shivering increased with the increase of intraoperative blood loss(P<0.05),and the incidence of shivering in epidural anesthesia was lower than that in spinal anesthesia and combined epidural anesthesia(P<0.05).The results of multivariate Logistic regression analysis showed that young adults,male,long operation time,excessive intraoperative blood loss,spinal anesthesia and combined hard-lumbar anesthesia were independent risk factors for shivering after anesthesia.The markedly effective rate in the observation group was significantly higher than that in the control group(P<0.05),but there was no significant difference in effective rate,ineffici
作者
郭超
李福菁
陈明富
郑颖玲
梁柏勇
高涛
GUO Chao;LI Fu-jing;CHEN Ming-fu;ZHENG Ying-ling;LIANG Bai-yong;GAO Tao(Department of Anesthesiology,Shenzhen Integrated Traditional Chinese and Western Medicine Hospital,Shenzhen,Guangdong 518000;Department of Anesthesiology,Shenzhen People’s Hospital,Shenzhen,Guangdong 518000)
出处
《智慧健康》
2021年第19期70-72,共3页
Smart Healthcare
关键词
椎管内麻醉
术后
寒战
影响因素
布托啡诺
盐酸曲马多
治疗效果
Intraspinal anesthesia
Postoperative
Shivering
Iinfluencing factors
Butorphanol
Tramadol hydrochloride
Therapeutic effect
