Department of Anesthesiology, The Affiliated Hospital, School of Medicine, UESTC Chengdu Women's & Children's Central Hospital, Chengdu, 610091, China.
BMC Pediatr. 2024 May 6;24(1):307. doi: 10.1186/s12887-024-04781-4.
Anorectal malformation is a common congenital problem occurring in 1 in 5,000 births and has a spectrum of anatomical presentations, requiring individualized surgical treatments for normal growth. Delayed extubation or reintubation may result in a longer intensive care unit (ICU) stay and hospital stay, increased mortality, prolonged duration of mechanical ventilation, increased tracheostomy rate, and higher hospital costs. Extensive studies have focused on the role of risk factors in early extubation during major infant surgery such as Cardiac surgery, neurosurgery, and liver surgery. However, no study has mentioned the influencing factors of delayed extubation in neonates and infants undergoing angioplasty surgery.
We performed a retrospective study of neonates and infants who underwent anorectal malformation surgery between June 2018 and June 2022. The principal goal of this study was to observe the incidence of delayed extubation in pediatric anorectal malformation surgery. The secondary goals were to identify the factors associated with delayed extubation in these infants.
We collected data describing 123 patients who had anorectal malformations from 2019 to 2022. It shows that 74(60.2%) in the normal intubation group and 49(39.8%) in the longer extubation. In the final model, anesthesia methods were independently associated with delayed extubation (P < 0.05).
We found that the anesthesia method was independently associated with early extubation in neonates and infants who accepted pediatric anorectal malformation surgery.
肛门直肠畸形是一种常见的先天性问题,每 5000 例出生中就有 1 例,其解剖学表现具有多样性,需要个体化的手术治疗以促进正常生长。延迟拔管或重新插管可能导致重症监护病房(ICU)停留时间和住院时间延长、死亡率增加、机械通气时间延长、气管切开率增加以及住院费用增加。大量研究集中于危险因素在心脏手术、神经外科手术和肝脏手术等重大婴儿手术中早期拔管的作用。然而,尚无研究提及接受血管成形术手术的新生儿和婴儿中延迟拔管的影响因素。
我们对 2018 年 6 月至 2022 年 6 月期间接受肛门直肠畸形手术的新生儿和婴儿进行了回顾性研究。本研究的主要目的是观察小儿肛门直肠畸形手术中延迟拔管的发生率。次要目标是确定与这些婴儿延迟拔管相关的因素。
我们收集了 2019 年至 2022 年期间 123 例患有肛门直肠畸形患者的数据。结果显示,在正常插管组中,有 74 例(60.2%)患者在正常时间内拔管,而在延长插管组中,有 49 例(39.8%)患者需要延长拔管时间。在最终模型中,麻醉方法与延迟拔管独立相关(P<0.05)。
我们发现,麻醉方法与接受小儿肛门直肠畸形手术的新生儿和婴儿的早期拔管独立相关。