摘要
目的 探讨右美托咪定联合动画片干预对防治全麻腹腔镜疝囊高位结扎术患儿术后行为改变的临床意义.方法 选取2020 年4 月—2022 年12 月择期行全麻腹腔镜疝囊高位结扎术的患儿270 例为研究对象,根据就诊序号采用电脑随机数字表法分为A组(予以右美托咪定干预)、B组(予以动画片干预)、C组(予以右美托咪定联合动画片干预),每组90 例.比较3 组不同时间点平均动脉压(MAP)、心率(HR)、呼气末二氧化碳分压(PET CO2)、血氧饱和度(SpO2)、呼吸频率(RR)、改良耶鲁围术期焦虑量表(mYPAS)评分以及诱导期合作度量表(ICC)评分、苏醒期躁动评分量表(PAED)评分、躁动发生率、苏醒情况、术后行为改变情况.结果 在术前麻醉准备期间(T2)、入手术室(T3)、术后苏醒即刻(T4),C组HR、MAP低于A组、B组(P＜0.05).3 组PET CO2、SpO2、RR在组间、时间及组间·时间交互作用比较差异均无统计学意义(P＞0.05).T2、T3 时,C组mYPAS评分低于A组、B组(P＜0.05).C组ICC、PAED评分及苏醒期躁动率低于A组、B组(P＜0.05).术后1、7d,C组行为改变发生率低于A组、B组(P＜0.05).3 组拔管时间、意识恢复时间、麻醉恢复室停留时间及不良事件总发生率比较差异无统计学意义(P＞0.05).结论 右美托咪定联合动画片干预可降低行全麻腹腔镜疝囊高位结扎术患儿术前焦虑,提升患儿麻醉诱导合作程度,降低苏醒期躁动及术后行为改变发生率,且对患儿血流动力学影响较小,安全性高.
Abstract
Objective To explore the clinical significance of Dexmedetomidine combined animation intervention in preventing and treating postoperative behavioral changes in children undergoing laparoscopic high ligation of hernia sac under general anesthesia.Methods A total of 270 children who underwent elective laparoscopic high ligation of hernia sac under general anesthesia from April 2020 to December 2022 were selected as the research subjects,and were divided into group A(with Dexmedetomidine intervention,n =90),group B(with animation intervention,n =90),and group C(with Dexme-detomidine and animation intervention,n =90)according to the treatment sequence number by computer random number table method.The mean arterial pressure(MAP),heart rate(HR),end-expiratory partial pressure of carbon dioxide(PETCO2),blood oxygen saturation(SpO2),respiratory rate(RR),modified Yale Perioperative Anxiety Scale(mYPAS)score,Induc-tion Compliance Checklist(ICC)score and pediatric anesthesia emergence delirium scale(PAED)score,incidence of agita-tion,recovery,and postoperative behavior change at different time points were compared among the three groups.Results HR and MAP in group C were lower than those in group A and group B during preoperative anesthesia preparation,at the time of entering the operating room(T3)and immediately after recovery postoperatively(T4)(P＜0.05).There were no signifi-cant differences in the interaction between groups,time points and time points between groups with respect to PETCO2,SpO2 and RR among the three groups(P＞0.05).At T2 and T3,mYPAS scores in group C were lower than those in groups A and B(P＜0.05).The scores of ICC,PAED and restlessness rate during the recovery period in group C were lower than those in groups A and B(P＜0.05).The incidence of behavior change in group C was lower than that in group A and group B at 1 d and 7 d after operation(P＜0.05).There was no significant difference in extubation time,consciousness recovery time,length of stay in anesthesia recovery room and the total incidence of adverse events among the three groups(P＞0.05).Con-clusion Dexmedetomidine combined with animation intervention can reduce the preoperative anxiety before general anesthesia in children undergoing laparoscopic high ligation of hernia sac under general anesthesia,improve the degree of cooperation in anesthesia induction,reduce the incidence of restlessness during the recovery period and postoperative behavior changes,and have little impact on the hemodynamics of children with high safety.
基金项目
河北省卫健委2022年度研究课题计划项目(20221749)
维普
万方数据