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许碧香 黄惠榕 危椠罡 陈水凤 王 玫.全麻患者苏醒期躁动影响因素的Meta分析[J].中国现代医生,2021,59(14):1-6+11
全麻患者苏醒期躁动影响因素的Meta分析
Meta-analysis of influencing factors of emergence agitation in patients with general anesthesia
  
DOI:
中文关键词:  全身麻醉  苏醒期躁动  影响因素  Meta 分析
英文关键词:General anesthesia  Emergence agitation  Influencing factors  Meta analysis
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作者单位
许碧香 黄惠榕 危椠罡 陈水凤 王 玫 福建中医药大学附属人民医院护理部福建福州 350004 
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中文摘要:
      目的 探讨全麻患者苏醒期躁动(EA)发生的相关影响因素。方法 检索CNKI、Wanfang、VIP、PubMed、Cochrane Library、Embase 等数据库,收集建库至2020 年1 月19 日有关EA 影响因素的文献。根据纳入及排除标准筛选文献,并对纳入文献进行质量评价,采用RevMan5.3 软件进行Meta 分析。结果 共纳入26 篇文献,共计21 179 例观察对象,其中病例组3182 例,对照组17 997 例。Meta 分析结果显示,两组男性、吸烟史、合并高血压、脑外伤或脑梗死病史、合并糖尿病、术前焦虑、气管插管、留置导尿管、手术时间、麻醉时间、药物催醒、术后疼痛、低氧(SpO2<90%)、麻醉恢复室停留时间等因素与全麻术后EA 的发生有关,差异有统计学意义(P<0.05);亚组分析显示,吸入麻醉、麻醉诱导后留置尿管、开胸手术、普外科手术、ASAⅡ级、ASAⅢ级、术中开放性补液等因素是EA 的危险因素,差异有统计学意义(P<0.05)。结论 在临床治疗过程中应充分了解患者的个体情况,整体预测和识别高危患者,制订针对性措施预防苏醒期躁动的发生。
英文摘要:
      Objective To investigate the related factors of the occurrence of emergence agitation (EA) in patients with general anesthesia.Methods We searched databases such as CNKI,Wanfang,VIP,PubMed,Cochrane Library,Embase,etc.,and collected literature on the influencing factors of EA from the establishment of the database to January 19,2020.According to the inclusion and exclusion criteria,the literature was screened,and the quality of the included literature was evaluated.A meta-analysis was performed using RevMan5.3 software.Results Twenty-six literatures were included,and 21 179 observation subjects were included,including 3182 cases in the case group and 17 997 cases in the control group.Meta analysis results showed that the factors of gender,smoking history,hypertension,cerebral trauma or cerebral infarction history,diabetes,preoperative anxiety,tracheal intubation,indwelling catheter,operation time,anesthesia time,drug wake-up,postoperative pain,hypoxia(SpO2<90%),residence time in anesthesia recovery room,were related to the occurrence of EA after general anesthesia,and the difference was statistically significant(P<0.05).Subgroup analysis showed that inhalation anesthesia,indwelling catheter after anesthesia induction,thoracotomy,general surgery,ASA grade Ⅱ,ASA grade Ⅲand open fluid rehydration were EA risk factors,the difference was statistically significant(P<0.05).Conclusion In the course of clinical treatment,we should fully understand the individual situation of patients,overall predict and identify high-risk patients,and formulate targeted measures to prevent the occurrence of emergence agitation.
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