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小儿麻醉后恢复评分与术后早期低氧血症相关性的观察

Observation of the correlation of postanaesthesia recovery scores with early postoperative hypoxaemia in children.

作者信息

Xue F S, Tong S Y, Liao X, Liu J H, Zhang R J, An G, Luo L K

机构信息

Department of Anaesthesia, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

出版信息

Paediatr Anaesth. 1999;9(2):145-51. doi: 10.1046/j.1460-9592.1999.9220256.x.

Abstract

To observe the correlation of the postanaesthesia recovery score (PARS) with the incidence, and severity of early postoperative hypoxaemia in children, 1213 infants and children, ASA physical status I, aged three months to 14 years, scheduled for elective plastic surgery were included in this study. Arterial oxygen saturation (Spo2) levels were recorded while children were breathing room air shortly after arrival in the recovery room (0 min), and 5, 10, 15, 20, 30, 40, 50, 60, 120 and 180 min thereafter. The PARS was also determined on all patients when Spo2 levels were recorded in the recovery room. On the basis of different PARS, children were divided into the three groups: Group 1-children having the PARS of < or = 6; Group 2-children having the PARS of 7-9; and Group 3-children having a PARS of 10. The results showed that during the early postoperative period, the incidence and severity of hypoxaemia correlated closely with the PARS. The lower the children's PARS, the higher the incidences of hypoxaemia (Spo2 = 86-90%) and severe hypoxaemia (Spo2 < or = 85%). The incidences of hypoxaemia and severe hypoxaemia were 12.9% and 15.8%, respectively, in Group 1, 20.9% and 2.9% in Group 2, 0.8% and 0% in Group 3. There were significant differences among the three groups. Of the 91 children who required O2 supplementation in the recovery room because of low measured Spo2, 69 had the PARS of < or = 6, and 22 had the PARS of 7-8. It is concluded that if a patient has a PARS of 10, the patient will not need routine oxygen supplement because hypoxaemia will not occur.

摘要

为观察小儿麻醉后恢复评分(PARS)与术后早期低氧血症发生率及严重程度的相关性,本研究纳入了1213例年龄在3个月至14岁、ASA身体状况为I级、拟行择期整形手术的婴幼儿及儿童。在患儿进入恢复室后不久(0分钟)以及之后的5、10、15、20、30、40、50、60、120和180分钟,在患儿呼吸室内空气时记录动脉血氧饱和度(Spo2)水平。在恢复室记录Spo2水平时,还对所有患者进行了PARS测定。根据不同的PARS,将患儿分为三组:第1组——PARS≤6的患儿;第2组——PARS为7 - 9的患儿;第3组——PARS为10的患儿。结果显示,术后早期低氧血症的发生率及严重程度与PARS密切相关。患儿的PARS越低,低氧血症(Spo2 = 86 - 90%)和严重低氧血症(Spo2≤85%)的发生率越高。第1组低氧血症和严重低氧血症的发生率分别为12.9%和15.8%,第2组为20.9%和2.9%,第3组为0.8%和0%。三组之间存在显著差异。在恢复室因Spo2测量值低而需要补充氧气的91例患儿中,69例PARS≤6,22例PARS为7 - 8。结论是,如果患者的PARS为10,则患者无需常规吸氧,因为不会发生低氧血症。

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