七氟醚吸入诱导配合护理干预用于小儿上肢骨科手术60例临床评价

Sevoflurane Inhalation Induction Coordinated with Nursing Intervention in Pediatric Upper Extremity Orthopedic Surgery in 60 Cases

目的探讨七氟醚吸入诱导配合护理干预用于小儿上肢骨科手术的效果及其对穿刺成功的影响。方法选择2014年收治并拟行上肢骨科手术的患儿120例,按随机数字表法分为治疗组和对照组,各60例,治疗组患儿给予七氟醚吸入诱导及维持全身麻醉(简称全麻),同时配合护理干预;对照组患儿给予氯胺酮基础麻醉和丙泊酚维持全麻。结果治疗组一次性静脉穿刺成功率为100.00%,明显高于对照组的88.33%(P<0.05);对照组术中、术毕及苏醒时的心率(HR)明显高于术前(P<0.05),而治疗组略有上升(P>0.05),且波动明显小于对照组(P<0.05);对照组苏醒时的呼吸频率(R)较术前明显加快(P<0.05),而治疗组无明显变化(P>0.05),且波动明显小于对照组(P<0.05);治疗组麻醉诱导时间、疼痛反射消失时间及停药至苏醒时间均较对照组短(P<0.05),诱导期合作度评分明显低于对照组(P<0.05);治疗组患儿不良反应发生率为6.67%,明显低于对照组的21.67%(P<0.05)。结论七氟醚吸入诱导配合护理干预用于小儿上肢骨科手术疗效确切,可提高一次性静脉穿刺成功率,且能改善患儿在全麻插管诱导期的合作程度,维持血流动力学稳定,且术后苏醒快,不良反应较少,值得临床推广。

Objective To investigate the clinical efficacy of sevoflurane inhalation induction coordinated with nursing intervention in pediatric upper extremity orthopedic surgery and its influence on the venipuncture success rate. Methods Totally 120 children cases undergoing upper extremity orthopedic surgery in the hospital in 2014 were selected and randomly divided into the treatment group and control group according to the random number table,60 cases in each group. The treatment group was given sevoflurane inhalation induction and maintaining general anesthesia combined with the nursing intervention; the control group was given the ketamine basal anesthesia and propofol- based maintaining general anesthesia. Results The once venipuncture success rate in the treatment group was100%,which was significantly higher than 88. 33% in the control group（ P〈0. 05）; The heart rate（ HR） during operation,at the end of operation and awaking in the control group was significantly higher than that before operation（ P〈0. 05）,but which in the treatment group was slightly elevated（ P〉0. 05）,the fluctuation in the treatment group was significantly less than that in the control group（ P〈0. 05）;the respiratory rate（ R） at awaking in the control group was significantly accelerated compared with before operation（ P〈0. 05）,while which in the treatment to group had no obvious change（ P〈0. 05）,the fluctuation in the treatment group was significantly less than that in the control group（ P〈0. 05）; the anesthesia induction time,pain reflex disappearance time and time from drug withdrawal to awaking in the treatment group were shorter than those in the control group（ P〈0. 05）,the cooperation score during induction period in the treatment group was significantly lower than that in the control group（ P〈0. 05）; the occurrence rate of adverse reactions in the treatment group was 6. 67%,which was significantly lower than 21. 67% in the control group（ P〈0. 05）. Conclusion Sevoflurane inhalation induction coordinated with nursing intervention used in children patients with upper extremity orthopedic surgery has definite efficacy,can increase the once venipuncture success rate,improve the cooperation degree of children patients in the intubation induction period of general anesthesia for maintaining hemodynamic stability,has rapid postoperative recovery and few adverse reactions,which is worthy of promotion in clinic.