摘要
【目的】探讨童趣视频宣教联合母亲陪伴干预对学龄前全身麻醉患儿围手术期不良结局的影响,包括麻醉诱导配合度,围手术期焦虑、苏醒期疼痛和躁动情况。【方法】本研究选择2023年6月至12月期间在我院接受全身麻醉的300例学龄前期手术患儿作为研究对象,随机将患者分为对照组和干预组,每组各150例。对照组实施常规复苏,而干预组在常规复苏的基础上,术前一天访视,母亲与患儿共同观看手术麻醉童趣视频且接受宣教,入手术室等候和术后苏醒30 min时,母亲分别被引导陪伴患儿持续超过30 min。通过手术麻醉信息系统记录复苏情况并使用改良耶鲁围手术期焦虑量表(m-YPAS)、麻醉诱导期合作量表(ICC)、儿童疼痛行为量表(FLACC)及儿童躁动评估量表(PAED)评估和记录患儿麻醉诱导配合度,围手术期焦虑、疼痛和躁动情况。【结果】术前一天访视时,两组患儿一般资料差异无统计学意义(P>0.05)。围手术期焦虑方面,干预组的mYPAS评分显著低于对照组(入手术室等候时35.27±6.48比41.79±6.68,P<0.05;术后苏醒30 min时20.13±7.05比35.75±9.51,P<0.05)。麻醉诱导配合度方面,干预组ICC评分显著低于对照组(1.84±0.95比3.17±0.62,P<0.05),且诱导配合度良好的比例显著高于对照组(24.00%比12.67%,P<0.05)。苏醒时长无明显差异,但复苏室停留时长显著短于对照组[(0.90±0.29)h比(1.29±0.42)h,P<0.001]。围手术期躁动方面,干预组PAED评分显著低于对照组(入手术室等候时8.5比9.2,P<0.05;术后苏醒30 min时4.2比7.8,P<0.05)。疼痛评分方面,干预组FLACC评分也显著低于对照组(入手术室等候时5.3比6.7,P<0.05;术后苏醒30 min时2.1比4.9,P<0.05)。【结论】童趣视频宣教与母亲陪伴的联合干预策略有效降低学龄前期全身麻醉手术患儿的围手术期焦虑、疼痛、躁动,提高麻醉诱导依从性,建议在临床实践中推广应用此干预措施。
【Objective】To investigate the effect of video-based educational intervention combined with maternal presence on perioperative adverse outcomes in preschool children undergoing general anesthesia,including cooperation in anesthesia induction,perioperative anxiety,pain and agitation during recovery.【Methods】A total of 300 preschool children scheduled for general anesthesia in our hospital from June to December 2023 were randomly assigned to control group(n=150)and intervention group(n=150).The control group received routine recovery care.For the intervention group,in addition to routine recovery care,a preoperative visit was scheduled one day before surgery.During this visit,mothers were guided to watch anesthesia videos with their children.During the waiting period in the operating room and 30 minutes after awakening,the mothers were guided to accompany the children for more than 30 minutes.Recovery conditions were recorded using the surgical anesthesia information system,and the children’s anesthetic induction compliance,perioperative anxiety,pain,and agitation were evaluated and recorded using the modified Yale Preoperative Anxiety Scale(m-YPAS),the Induction Compliance Scale(ICC),the Children’s Pain Behavior Scale(FLACC),and the Pediatric Agitation and Emergence Delirium Scale(PAED).【Results】On the preoperative visit day,there were no statistically significant differences in baseline data between the two groups(P>0.05).For perioperative anxiety,the m-YPAS scores of the intervention group were significantly lower than those of the control group,both when entering the operating room waiting area(35.27±6.48 vs.41.79±6.68,P<0.05)and 30 minutes after postoperative recovery(20.13±7.05 vs.35.75±9.51,P<0.05).In terms of anesthesia induction cooperation,the ICC scores of the intervention group were significantly lower than those of the control group(1.84±0.95 vs.3.17±0.62,P<0.05),and the proportion of good induction cooperation was significantly higher than that of the control group(24.00%vs.12.67%,P<0.05).There was no significant difference in awakening duration between the two groups,but the intervention group had a significantly shorter length of stay in the post-anesthesia care unit than the control group(0.90±0.29 hours vs.1.29±0.42 hours,P<0.001).For perioperative agitation,the PAED scores of the intervention group were significantly lower than those of the control group(entering in the operating room waiting area:8.5 vs.9.2,P<0.05;30 minutes after postoperative recovery:4.2 vs.7.8,P<0.05).In terms of pain scores,the FLACC scores of the intervention group were also significantly lower than those of the control group,both when entering the operating room waiting area(5.3 vs.6.7,P<0.05;30 minutes after postoperative recovery:2.1 vs.4.9,P<0.05).【Conclusions】Video-based educational intervention combined with maternal presence reduces the perioperative anxiety,pain and agitation of preschool children undergoing general anesthesia,and improved the compliance of anesthesia induction.It is recommended to promote this intervention measure in clinical practice.
作者
谭嘉裕
龚凤球
黄文起
冯霞
朱琼芳
康玉博
吴文燕
李秀红
TAN Jiayu;GONG Fengqiu;HUANG Wenqi;FENG Xia;ZHU Qiongfang;KANG Yubo;WU Wenyan;LI Xiuhong(School of Public Health,Sun Yat-sen University,Guangzhou 510080,China;The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510058,China;School of Public Health,Sun Yat-sen University,Shenzhen 518107,China)
出处
《中山大学学报(医学科学版)》
北大核心
2025年第3期519-527,共9页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省基础与应用基础研究基金(2021A1515011757)。
关键词
学龄前
全麻患儿
视频宣教
母亲陪伴
围手术期
pre-school age
children under general anesthesia
video-based education
maternal presence
perioperative period
作者简介
第一作者:谭嘉裕,研究方向:公共卫生,E-mail:tanjy33@mail.sysu.edu.cn;通信作者:李秀红,教授,E-mail:lixh@mail.sysu.edu.cn。
