应柳　王海英　林敏红　汤卫红　杭金国　管敏昌

[摘要] 目的 了解儿童纤维支气管镜术不良事件相关危险因素，并提出相关护理对策。 方法 选取2012年7月～2015年7月杭州市第一人民医院儿科病房行纤维支气管镜术的患儿80例，按是否出现不良事件分为观察组和对照组各40例，采用单因素和多因素 Logistic回归分析。 结果 单因素Logistic回归分析结果表明：年龄、手术时间、基础疾病3个因素为儿童纤维支气管镜不良事件危险因素；多因素Logistic回归分析显示，年龄（OR：16.628，95%CI：1.688～163.764）、基础疾病（OR：9.369，95%CI：1.429～61.412）、手术时间（OR：15.252，95% CI：1.767～131.676）是儿童纤维支气管镜不良事件的独立危险因素。 结论 儿童纤维支气管镜术应重视有基础疾病和手术时间长的小年龄患者，并采取相应的护理措施，以减少不良事件的发生。

[关键词] 纤维支气管镜；不良事件；危险因素；护理措施； Logistic回归分析

[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2015）35-0135-04

[Abstract] Objective To investigate risk factors of the adverse event during the fiberoptic bronchoscopy in children and to give some related nursing strategies. Methods Eighty cases were enrolled from pediatric department of the first people's hospital of hangzhou， who were performed by bronchoscope from July 2012 to July 2015， and were divided into the observation group and the control group according to whether appeared the adverse event， with 40 patients each， then univariate and multivariate Logistic regression analysis were adopted. Results Univariate logistic regression analysis showed that age， basic disease and operation time were the risk factors of the adverse event during the fiberoptic bronchoscopy in children. Multivariate logistic regression analysis showed that age（OR：16.628，95%CI：1.688-163.764）， basic disease （OR：9.369，95%CI：1.429-61.412）， operation time （OR：15.252，95%CI：1.767-131.676）， were independent risk factors of the adverse event during the fiberoptic bronchoscopy in children. Conclusion More attention should be paid to the younger patients with underlying diseases and long operation time， and corresponding nursing measures should be applied to reduce the adverse event when performed by bronchoscope.

[Key words] Bronchoscope； Adverse event； Risk factors； Nursing measures； Logistic regression analysis

近年來，随着纤维支气管镜术在基层医院儿科逐渐开展，支气管肺泡灌洗应用越来越广泛[1，2]。纤维支气管镜在小儿呼吸道发育的诊断和难治性呼吸道疾病的诊治中优势逐渐被认可。但在儿科领域中由于受到儿童气道小和技术要求的影响，使得纤支镜应用受到一定的限制。纤维支气管镜潜在的危险性越来越受到重视。然而，查阅文献，尚无儿童纤维支气管镜相关危险因素及防治对策的报告。近年来，我院内镜中心在儿科呼吸道疾病诊治中广泛开展了纤维支气管镜检查，通过有效护理措施，在如何减少儿童支气管镜术中的不良事件方面也积累了一些经验。……