认知干预对口腔治疗儿童七氟烷全身麻醉后苏醒期躁动的作用研究

Study on effects of cognitive intervention to emergence agitation of children subject to sevoflurane general anesthesia in oral treatment

目的：探讨认知干预对门诊七氟烷吸入全身麻醉的学龄前儿童苏醒期躁动的抑制作用。方法将100例学龄前患儿采用随机数字表法将其分为试验组52例和对照组48例。试验组采用麻醉医生、手术医生、四手护士对患儿及家长进行术前有效认知干预及其他常规全身麻醉手术护理。对照组采用麻醉医生、手术医生、四手护士对患儿及家长进行常规的全身麻醉手术护理。观察比较2组患儿应用全身麻醉苏醒期躁动评分量表（PAED）的评分、苏醒期躁动发生率、苏醒期躁动的持续时间。结果 PAED评分、苏醒期躁动的持续时间试验组分别为（10.27±5.11）分和（9.57±2.46）min，对照组分别为（13.17±4.55）分和（12.68±4.01）min，差异有统计学意义（F=2.453、1.980，P＜0.01或0.05），苏醒期发生躁动、嗜睡试验组分别为21例、14例，对照组分别为34例、6例，差异有统计学意义（χ2=9.530、3.245，P＜0.01或0.05），恶心、呕吐试验组为2例，对照组为4例，差异无统计学意义（χ2=0.891，P=0.345）。结论通过术前有效的认知干预，对门诊学龄前患儿七氟烷全身麻醉苏醒期躁动起到了抑制作用。

Objective To discuss the inhibiting effects of cognitive intervention to treatment of emergence agitation in preschool children subject to sevoflurane general anesthesia. Methods 100 preschool children were divided into experimental group (n=52) and control group (n=48) with the methods of random number table. Take effective preoperative cognitive intervention and other regular general anesthesia operating nursing to patients and parents by anesthesiologists, surgeons and assistant nurse in experimental group. Take regular general anesthesia operating nursing to patients and parents by anesthesiologists, surgeons and assistant nurse in control group. Observe and compare the Pediatric anesthesia Emergence Delirium Scale (PAED) score, incidence rate of emergence agitation and duration of emergence agitation of the two groups. Results The PAED scores and duration in the recovery period in experimental group were (10.27±5.11) points and (9.57±2.46) min while control group were (13.17±4.55) points and (12.68 ± 4.01) min (F=2.453, 1.980, P<0.01 or 0.05). Number of dysphonia during recovery period and hypersomnia in experimental group were 21 cases and 14 cases while control group were 34 cases and 6 cases(χ2=9.530, 3.245, P<0.01 or 0.05). Nausea and vomiting in experimental group were 2 cases and control group were 4 cases (χ2=0.891, P=0.345). Conclusions Taking effective preoperative cognitive intervention to patients has inhibiting effects on treating emergence agitation in children subject to sevoflurane general anesthesia.