基于体温为照护导向的精细化管理在手术麻醉苏醒期患儿中的应用

Application of Care-oriented Meticulous Management Based on Body Temperature in Children during Postoperative Anesthesia Recovery

目的:探讨在手术麻醉苏醒期患儿中开展基于体温为照护导向的精细化管理的临床应用效果。方法:选取2019年1月1日~12月31日收治的86例手术患儿为研究对象,采用随机数字表法分为对照组和观察组各43例;对照组给予常规护理,观察组在麻醉苏醒期开展基于体温为照护导向的精细化管理;比较两组进入麻醉苏醒室、拔管后15 min苏醒期谵妄情况[采用小儿全麻苏醒期谵妄量表(PAED)],比较两组麻醉苏醒期躁动情况、苏醒时间、麻醉苏醒期并发症发生率。结果:两组拔管后15 min的PAED得分与进入麻醉苏醒室时比较均升高(P<0.05),而观察组低于对照组(P<0.05);观察组躁动分级及发生率均低于对照组(P<0.01);两组自主呼吸时间比较差异无统计学意义(P>0.05);观察组语唤睁眼、张口时间,遵令握拳、动手足时间,拔管时间均短于对照组(P<0.05);观察组寒战、体温异常发生率低于对照组(P<0.05)。结论:对麻醉苏醒期手术患儿开展基于体温为照护导向的精细化管理,有利于减少患儿麻醉苏醒期谵妄、躁动的发生,促进患儿苏醒,减少麻醉苏醒期并发症的发生。

Objective:To investigate the clinical effect of care-oriented meticulous management based on body temperature in children during postoperative anesthesia recovery.Methods:A total of 86 cases of children admitted from January 1 to December 31,2019 were selected as the research objects,and divided into control group and observation group by random number table method,with 43 cases each.The control group received routine nursing,while the observation group carried out care-oriented meticulous management based on body temperature during the waking period of anesthesia.The delirium in the waking phase after the admission to the anesthesia recovery room and 15 minutes after extubation was compared between the two groups.The agitation,waking time and incidence of complications in the waking phase of anesthesia were compared between the two groups.Results:The PAED score of 15 minutes after extubation in both groups was higher than that after admission to the anesthesia recovery room(P<0.05),while that in the observation group was lower than that in the control group(P<0.05).The severity and incidence of agitation in the observation group were lower than those in the control group(P<0.01).There was no significant difference in spontaneous breathing time between the two groups(P>0.05).In the observation group,the time of opening eyes and opening mouth,the time of clenching fist and starting hands,and the time of extubation were shorter than those in the control group(P<0.05).The incidence of chills and temperature anomalies in the observation group was lower than that in the control group(P<0.05).Conclusion:Meticulous management based on body temperature is beneficial to reduce the occurrence of delirium and agitation during anesthesia recovery period,promote the recovery of children,and reduce the occurrence of complications during anesthesia recovery period.