趣味化麻醉诱导联合感受模拟的护理对行疝囊修补术学龄前患儿麻醉配合度的影响

Influence of Entertaining Anesthesia Induction Combined with Sensory Simulation Nursing on Anesthesia Cooperation of Preschool Children Undergoing Herniorrhaphy

目的:探讨趣味化麻醉诱导联合感受模拟的护理对行疝囊修补术学龄前患儿麻醉配合度的影响。方法:选取2019年3月—2021年3月复旦大学附属儿科医院厦门医院收治的89例行疝囊修补术学龄前患儿为研究对象。随机将其分为两组,对照组44例,观察组45例。对照组麻醉诱导前采用基于感受模拟的常规护理,观察组采用趣味化麻醉诱导联合感受模拟的护理。对比两组术前1 d访视时(T_(1))、术前等候15 min时(T_(2))、麻醉诱导时(T_(3))的改良耶鲁围手术期焦虑量表(Cm-YPAS)评分、心率(HR)、平均动脉压(MAP),T_(3)麻醉诱导期合作量表(ICC)评分、术后恢复时间及术后并发症发生情况。结果:两组T_(1)的Cm-YPAS评分比较,差异无统计学意义(P>0.05),T_(2)和T_(3),观察组的Cm-YPAS评分较对照组低,差异有统计学意义(P<0.05)。T_(3),观察组ICC评分为(1.87±0.58)分,对照组患儿ICC评分为(3.25±1.05)分,观察组ICC评分低于对照组,差异有统计学意义(P<0.001)。两组T_(1)的HR、MAP比较,差异无统计学意义(P>0.05);T_(2),观察组的HR低于对照组,差异有统计学意义(P<0.05),两组MAP比较差异无统计学意义(P>0.05);T_(3),观察组的HR、MAP较对照组低,差异有统计学意义(P<0.05)。两组复苏时间及肠道排气时间比较,差异无统计学意义(P>0.05),观察组住院时间较对照组短,差异有统计学意义(P<0.05)。观察组家属满意度评分为(90.37±2.78)分,高于对照组的(87.29±3.17)分,差异有统计学意义(P<0.001)。观察组术后并发症发生率为6.67%,较对照组的11.36%低,但差异无统计学意义(P>0.05)。结论:趣味化麻醉诱导联合感受模拟的护理有助于提高患儿麻醉配合度,缓解术前焦虑、稳定心率及血压,还可促进术后恢复,缩短住院时间,提高家属满意度。

Objective:To explore the influence of entertaining anesthesia induction combined with sensory simulation nursing on anesthesia cooperation of preschool children undergoing herniorrhaphy.Method:A total of 89 preschool children undergoing herniorrhaphy admitted in Children's Hospital of Fudan University at Xiamen from March 2019 to March 2021 were selected as the study objects.They were randomly divided into two groups,the control group of 44 cases and observation group of 45 cases.The control group received routine nursing based on sensory simulation before anesthesia induction,and the observation group received entertaining anesthesia induction combined with sensory simulation nursing.The modified Yale perioperative anxiety scale(Cm-YPAS)scores,heart rate(HR)and mean arterial pressure(MAP)of the two groups were compared at 1 d preoperative visit(T_(1)),15 min preoperative wait(T_(2))and induction of anesthesia(T_(3)),cooperative scale of anesthesia induction(ICC)score at T_(3),postoperative recovery time and postoperative complications were compared between the two groups.Result:There was no statistical significance in Cm-YPAS score of T_(1) between the two groups(P>0.05),while the Cm-YPAS scores of T_(2) and T_(3) in the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The ICC score of T_(3) in the observation group was(1.87±0.58)points,the ICC score of the control group was(3.25±1.05)points,and the ICC score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.001).There were no significant differences in HR and MAP of T_(1) between the two groups(P>0.05).T_(2),HR in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05),while MAP comparison had no statistically significant difference between the two groups(P>0.05).T_(3),HR and MAP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in resuscitation time and intestinal exhaust time between the two groups(P>0.05),and the hospitalization time of the observation group was shorter than that of the control group,the difference was statistically significant(P<0.05).The satisfaction score of family members in the observation group was(90.37±2.78)points,higher than that in the control group(87.29±3.17)points,and the difference was statistically significant(P<0.001).The incidence of postoperative complications in the observation group was 6.67%,lower than Chinese and Foreign Medical Research Vol.21,No.34 December,202311.36%in the control group,but the difference was not statistically significant(P>0.05).Conclusion:Entertaining anesthesia induction combined with sensory simulation nursing can help improve the degree of anesthesia cooperation of children,relieve preoperative anxiety,stabilize heart rate and blood pressure,and promote postoperative recovery,shorten hospital stay and improve family satisfaction.