麻醉前认知干预对降低颅内肿瘤术后全麻躁动发生率的作用

Effect of cognitive intervention on reducing the incidence of postoperative agitation in patients with intracranial tumors

目的 探讨麻醉前认知干预对降低颅内肿瘤患者术后全麻躁动发生率的作用。方法 将80例行颅内肿瘤全麻手术患者随机分为观察组及对照组各40例,对照组采用常规性护理,观察组在对照组基础上行麻醉前认知干预,记录2组患者入室时（T0）、手术即刻（T_1）、手术切皮后30 min（T_2）、拔除气管导管时（T_3）的心率（HR）、收缩压（SBP）、舒张压（DBP）、脉搏血氧饱和度（SpO_2）、血浆血糖、肾上腺素及皮质醇的浓度及术后麻醉苏醒躁动、恶性呕吐发生情况与镇痛药物使用情况。结果 2组患者在T_0~T_3时段的HR、SpO_2差异有统计学意义（P〈0.05）,2组患者在T_0~T_3时段的血浆血糖、肾上腺素及皮质醇浓度差异有统计学意义（P〈0.05）。观察组躁动评分显著低于对照组（P〈0.05）,术后镇痛药物使用率显著低于对照组（P〈0.05）,恶心呕吐及麻醉躁动发生率显著低于对照组（P〈0.05）。结论 麻醉前认知干预能有效减轻颅内肿瘤患者围术期应激反应,降低患者全麻躁动发生率。

Objective To investigate the effect of cognitive intervention on reducing the in- cidence of postoperative agitation in patients with intracranial tumors. Methods A total of 80 cases of intracranial tumor surgery under general anesthesia were randomly divided into observation group （ n - 40） and control group （ n = 40）, the control group was given routine care, and the observation group received cognitive intervention based on control group, heart rate （FIR）, systolic blood pres- sure （SBP） and diastolic blood pressure （DBP）, pulse oxygen saturation （SpO2）, plasma glucose, adrenaline and cortisol concentration and postoperative anesthesia restlessness, nausea and vomiting and analgesic drug use before entering the room （To ） , surgery （T1 ） , surgical incision after 30 rain （T2 ）, pulling out the tracheal catheter （T3 ） were recorded. Results There were statistically signifi- cant difference in HR and SpO2 of two groups during T0 - T3 （ P 〈 0.05 ） , and the plasma glucose, adrenaline and cortisol concentration in the two groups were statistically significant （P 〈 0.05 ）. The agitation score in the observation group was lower than in the control group （ P 〈 0.05 ） , and the a- mount of sedative drugs was significantly less than that inthe control group （P 〈 0.05 ）. Postoperative nausea, vomiting and restlessness were significantly lower than those in the control group （P 〈 0.05）. Conclusion Cognitive intervention can effectively reduce the perioperative stress in patients with intracranial tumors, and reduce the incidence of general anesthesia.