24-36个月的儿童在T&A后的夜间监测:它总是必要的吗?
Tyler Van Heest1,2, Luka Bahra3, Suhong Tong4
1Pediatric ENT and Facial Plastic Surgery, Children's Minnesota, Minneapolis, Minnesota, USA.
The Laryngoscope
|November 5, 2025
概括
3岁以下的儿童在3小时内不再需要氧气,并在桃体切除术 (T+/-A) 后通过睡眠室空气挑战 (AsRAC) 时,可以在当天放电. 慢性肺病 (CLD) 是长期氧气需求 (POR) 的危险因素.
科学领域:
- 儿科手术 儿科手术
- 麻醉学 麻醉学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 带或不带腺切除术 (T+/-A) 的桃体切除术是一种常见的儿科手术手术.
- 手术后的氧气需求可以延长幼儿的住院时间.
- 确定当天出院的安全标准对于优化儿科外科护理至关重要.
研究的目的:
- 评估T+/-A后3岁以下儿童当天放药的安全性.
- 为了确定是否在3小时内断奶氧和通过睡眠室空气挑战 (AsRAC) 是可靠的排放指标.
- 在这个患者群体中确定长期氧气需求 (POR) 的风险因素.
主要方法:
- 对645名24-36个月龄的儿童进行了回顾性研究,从2019-2021年开始接受T+/-A.
- 对人口,临床和多睡眠学 (PSG) 数据的分析.
- 基于长期氧气需求 (POR) 的分层和使用Kruskal-Wallis和Chi-squared/Fisher的精确测试进行统计比较.
主要成果:
- 81.2%的儿童在手术后3小时内停止使用氧气.
- 在3小时内脱氧的患者中,98.7%不需要重新氧化.
- 女性性别和慢性肺病 (CLD) 是POR的重要风险因素;手术前的PSG变量没有预测POR.
结论:
- 24-36个月的儿童在3小时内断氧,并通过ASRAC,是同一天T+/-A手术的合适候选人.
- 慢性肺炎是长期需要氧气的主要临床风险因素.
- 手术前的多睡眠学发现不能可靠地预测手术后的氧气需求.
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