复苏室家属陪伴对全身麻醉择期手术患儿复苏水平和心理的影响

Influence of parental companion in resuscitation room on the resuscitation level and psychology of children undergoing elective surgery under general anesthesia

目的探讨复苏室家属陪伴对全身麻醉择期手术患儿复苏水平和心理的影响。方法选择2020年1~6月在南充市中心医院行全身麻醉择期手术的患儿132例进行研究。采用随机数字表法将患儿分为对照组(n=66)和观察组(n=66)。对照组以常规模式进行复苏,观察组采取复苏室家属陪伴的模式进行复苏。比较两组患儿苏醒期的一般情况、躁动情况、疼痛情况、心理状况、术后不良行为发生情况及家属满意度。统计学方法采用t检验和χ^(2)检验。结果两组患儿出室时血氧饱和度、复苏室停留时间、改良Alderte评分及心率比较,差异均无统计学意义(P值均>0.05)。入室时两组患儿的儿童麻醉苏醒期躁动量化评分表(pediatric anesthesia emergence delirium,PAED)得分、儿童疼痛行为量表(face legs activity cry consolability,FLACC)得分比较,差异均无统计学意义(P值均>0.05);出室时观察组患儿PAED得分[(6.0±1.5)分]、FLACC得分[(2.4±0.5)分]均低于对照组[(7.7±2.0)分、(3.1±0.8)分,t值分别为5.213、6.587,P值均<0.05]。术前两组患儿医院焦虑抑郁量表(hospital anxiety and depression,HADS)的焦虑、抑郁维度得分比较,差异均无统计学意义(P值均>0.05);出室时对照组焦虑[(9.4±2.6)分]、抑郁得分[(8.9±1.7)分]高于术前[(5.4±1.1)分、(5.1±1.3)分,t值分别为11.835、14.519,P值均<0.05]。观察组术前与出室时焦虑、抑郁维度得分比较,差异均无统计学意义(P值均>0.05)。观察组患儿术后不良行为总发生率低于对照组(9.1%与22.7%,χ^(2)=4.587,P<0.05)。观察组患儿家属满意度得分高于对照组[(93.2±6.1)与(85.0±5.7)分,t=7.694,P<0.05)]。结论复苏室家属陪伴与常规复苏模式相比可有效缓解全身麻醉择期手术患儿躁动及疼痛,改善心理状况,减少术后不良行为发生率并提高家属满意度。

Objective To explore the influence of parental companion in the resuscitation room on the resuscitation level and psychology of children undergoing elective surgery under general anesthesia.Method From January to June 2020,132 children underwent general anesthesia and elective surgery in Nanchong Central Hospital were selected for the study.The children were divided into control group(n=66)and observation group(n=66)by random number table.The control group was resuscitated in a conventional mode,and the observation group was resuscitated in the mode of a parental companion in the resuscitation room.The general conditions,restlessness,pain,psychological condition,occurrence of postoperative bad behavior and parents'satisfaction in the two groups were compared.Statistical methods were performed by t test andχ^(2) test.Result There was no significant difference in oxygen saturation,stay time in the resuscitation room,modified Alderte score or heart rate between the two groups of children when they leaving the room(all P>0.05).There was no significant difference in pediatric anesthesia emergence delirium(PAED)score or face legs activity cry consolability(FLACC)pain assessment scale score between the two groups when entering the room(all P>0.05);when leaving the resuscitation room,the PAED score[(6.0±1.5)points]and the FLACC pain assessment scale[(2.4±0.5)points]in the observation group were lower than those in the control group[(7.7±2.0)and(3.1±0.8)points,t=5.213,6.587,all P<0.05].There was no significant difference in hospital anxiety and depression scale(HADS)anxiety or depression scores between the two groups of children before operation(all P>0.05);when leaving the resuscitation room,the anxiety score[(9.4±2.6)points]and depression score[(8.9±1.7)points]of the control group were higher than those before surgery[(5.4±1.1)and(5.1±1.3)points,t=11.835,14.519,all P<0.05].There was no significant difference in the scores of anxiety or depression(P>0.05).The total incidence of adverse behaviors in the observation group was lower than that in the control group(9.1%vs 22.7%,χ^(2)=4.587,P<0.05).The parents'satisfaction score of parents of children in the observation group were higher than that in the control group[(93.2±6.1)vs(85.0±5.7)points,t=7.694,P<0.05)].Conclusion Compared with the conventional resuscitation mode,the parental companion in the resuscitation room can effectively alleviate the agitation and pain of children undergoing elective surgery under general anesthesia,improve their psychological status,reduce the incidence of postoperative bad behaviors and increase parents'satisfaction.