许碧香　　黄惠榕　　危椠罡　　陈水凤　　王玫

[关键词] 全身麻醉;苏醒期躁动;影响因素;Meta分析

[中图分类号] R614          [文献标识码] A          [文章编号] 1673-9701（2021）14-0001-06

Meta-analysis of influencing factors of emergence agitation in patients with general anesthesia

XU Bixiang   HUANG Huirong   WEI Qiangang   CHEN Shuifeng   WANG Mei

Department of Nursing， the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine， Fuzhou 350004， China

[Abstract] 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 Ⅲ and 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.

[Key words] General anesthesia; Emergence agitation; Influencing factors; Meta analysis

全麻蘇醒期躁动（Emergence agitation，EA）是临床常见的麻醉并发症，为全麻术后患者苏醒期出现的一种不适当行为，常表现为兴奋、语无伦次、无理性言语、哭喊，出现肢体的无意识动作等[1]。EA可能对患者造成身体伤害，如疼痛加剧、出血、意外拔管等，并且可能需要物理或化学方法约束患者[1-2]。另外，EA也困扰着麻醉师和麻醉恢复室医务人员，甚至可能发生伤医行为[3]。目前，国内外已有多项关于EA发生的相关影响因素研究，但已有的临床研究和系统综述尚不够全面，且各个研究结果存有差异。本研究为最大程度利用现有研究，拟通过Meta分析明确EA发生的危险因素，为制订相关预防措施提供参考，现报道如下。

1 资料与方法

1.1 文献纳入与排除标准

纳入标准：①国内外公开发表的关于EA发生的影响因素研究;②研究类型为按照病例组（或躁动组）和对照组（无躁动组）分组的回顾性研究、横断面研究或前瞻性研究;③研究对象为全麻手术患者，年龄≥18岁，并有明确的EA评定标准;④文献语种限为英文或中文。排除标准：①重复发表的文献;②信息不完整、不清晰或设计有明显的缺陷、数据错误或不完整的文献;③无法获取全文的文献。

1.2 文献检索策略

计算机检索CNKI、Wanfang、VIP、PubMed、Cochrane Library、Embase等数据库。英文检索词包括Emergence Agitation/Agitation/Restlessness/Dysphoria;Risk Factor/Relevant Factor;Anesthesia/General Anesthesia/narcosis/anaesthetize。中文检索词包括麻醉/全麻、苏醒期/恢复/复苏、躁动/烦躁、危险因素/相关因素/影响因素。运用关键词和主题词相结合的方法，检索时间为建库至2020年1月19日。……