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日本剖腹产麻醉实践:一个回顾性队列研究
Hiroshi Yonekura1,2, Yusuke Mazda3, Shohei Noguchi3
1Department of Anesthesiology and Pain Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otoubashi, Nakagawa-Ku, Nagoya City, Aichi, 454-8509, Japan. hiroshi.yonekura@fujita-hu.ac.jp.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|November 13, 2023
概括
在日本,在剖腹产中使用全身麻醉在2005年至2021年期间显著下降. 然而,在其应用中仍然存在显著的机构间差异,突出了设施特定的做法.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 公共卫生 公共卫生
背景情况:
- 剖腹产的全身麻醉可以影响母亲和新生儿的结果.
- 了解麻醉的趋势和变化对于改善患者护理至关重要.
研究的目的:
- 评估日本16年间剖腹产麻醉管理的时间趋势.
- 分析在剖腹产中使用全身麻醉的机构间差异.
主要方法:
- 使用全国医疗保险索赔数据库 (2005-2021) 进行的回顾性队列研究.
- 包括2,496个机构的102,617例剖腹产.
- 分析了使用层次逻辑回归,中位数赔率和类内相关系数的机构变化.
主要成果:
- 在3.7%的剖腹产中使用全身麻醉.
- 一般麻醉使用率从2005年的10.8%下降到2021年的2.9%.
- 观察到有显著的机构间差异,设施差异解释了52%的实践差异.
结论:
- 虽然在日本,剖腹产时使用全身麻醉已经减少,但在3.7%的病例中,仍然是惯例.
- 在日本医疗机构中,全身麻醉的使用存在实质性的差异.
- 解决机构间的差异是标准化剖腹产麻醉实践的关键.
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