先天性心脏病患儿应用水合氯醛镇静后采集血气标本的临床效果观察

Observation on clinical effect of collecting blood gas specimen for children with congenital heart disease after sedation with chloral hydrate

[目的]探索一种先心病患儿术前准备中简单易行的动脉血样采集方法。[方法]选取准备接受手术治疗的住院先天性心脏病患儿60例,随机分为实验组和对照组,实验组血气标本采集时机选择在应用水合氯醛镇静后;对照组在常规入院后次日上午清醒时,比较两组患儿采血前、中、后的心率及血氧饱和度的变化、一次穿刺成功率及穿刺部位皮下血肿的发生情况、成功采集血气标本时患儿哭闹持续时间及完成采血时间。[结果]两组患儿采血前心率、血氧饱和度无差异(P>0.05);实验组患儿采血中及采血后1min、5min、10min的心率低于对照组(P<0.05),血氧饱和度高于对照组(P<0.05);一次动脉穿刺成功率高于对照组(P<0.05),穿刺部位皮下血肿的发生率低于对照组(P<0.05);实验组成功采集血气标本患儿的哭闹时间及完成采血时间均明显低于对照组(P<0.05)。[结论]水合氯醛镇静后采集血气标本增加了先天性心脏病患儿围术期术前护理操作的安全性,减少了患儿的痛苦,提高了护士的工作效率。

Objective： To probe into a simple and easy method of collec- ting artery blood specimen from children in preoperative preparation. Methods：A total of 60 cases of children with congenital heart disease in hospital preparing for surgery were randomly divided into experimental group and control group, and each group contained 30 cases. Blood gas specimen was collected after sedation with chloral hydrate in experimen- tal group and collected in the control group at waking up in the morning after addmition. The heart rate and oxygen saturation were compared be- fore,during and after between two groups blood collection. Success rate of one time puncture and the rate of local hematoma occurrence in puncture site as well as crying time before completion of collecting speci- men and finish time of collecting blood were compared between both groups. Results： There were no differences（P^0. 05） between both groups on heart rate and blood oxygen saturation before collecting blood. Heart rates during and after blood collecting （1 minute,5 minutes and 10 minutes） in experimental group were lower than than of control group（P~ 0.05） ,while its oxygen saturation and the success rate of one - time ar- tery blood gas puncture were higher（P%0.05）. Besides, the experimen- tal group had lower rate of hematoma occurrence and less crying time as well as finish time of blood collection compared with the control group（P% 0.05）. Conclusion：Collecting blood gas specimen after sedation in chil- dren with chloral hydrate can improve the safety of perioperative nursing operation for children with congenital heart disease, reduce the pain and enhance work efficiency of nurses.