小儿气管插管全麻苏醒期躁动观察及护理  

Nursing for emergence delirium in children after operation under general anesthesia

作　　者：邹岚[1] 吕凛生[1] 刘慧[1] 关健强[1] 

机构地区：[1]中山大学附属第三医院手术室,广州510630

出　　处：《中华腔镜泌尿外科杂志（电子版）》2011年第6期55-57,共3页Chinese Journal of Endourology(Electronic Edition)

基　　金：中山大学附属第三医院院基金(200709)

摘　　要：目的对气管插管全麻小儿手术后苏醒期躁动情况进行观察并总结护理经验。方法观察207例气管插管全麻小儿手术后在麻醉复苏室苏醒恢复情况,进行躁动评分（PAED）、镇痛评分（VAS）,记录并发症的发生情况并对护理情况予以评价。结果气管导管拔除后发生躁动65例。拔管后一过性低氧血症（SpO2〈90%）发生率25.1%（52/207）,面罩吸氧后改善;躁动造成气管导管滑脱8例,静脉输液外渗18例（其中留置针脱出5例）。拔管后10min、20min、30minPAED评分分别为10（2-18）,7（2-16）,6（1-16）,20min,30min组较10min组组间有统计学差异（P〈0.05）。非躁动患儿VAS评分率58.4%（83/142）,VAS为3（0-4）;躁动患儿VAS评分率53.89%（35/65）,VAS为3（0-5）,VAS组间无统计学差异（P〉0.05）。结论气管插管全麻小儿苏醒期躁动发生率高,并可导致严重并发症。苏醒期正确护理对减少并发症的发生及保证患儿的安全至关重要。Objective To explore the causes and nursing experiences of emergence delirium （ED） in children after operation under general anesthesia. Method A total of 207 pediatric patients with ED underwent operation who recovered from general anesthesia. ED and pain level were assessed using the pediatric anesthesia emergence delirium （PAED） and the visual analog scale （VAS）, respectively. Complications were observed and nursing effect were evaluated. Results ED occurred in 65 cases after tracheal extubation. The incidence of transient hypoxemia after extubation （SpO2 90%） was 25.1% （52/207） and the hypoxemia was improved after oxygen masks. The tracheal tube was pulled off in 8 cases as a result of ED. Extravasation of intravenous fluids in 18 cases （including 5 cases catheter dropped out）. 10, 20 and 30 minutes after tracheal extubation, PAED score were 10 （2-18）, 7 （2-16） and 6 （1-16）. There were significantly different between groups between the 10 min group and the 20 min or 30 min group （P〈0.05）. VAS score in children without ED was 58.4% （83/142）, VAS was 3 （0-4）. VAS score in children with ED was 53.89% （35/65）, VAS was 3 （0-5）. No difference was found among the groups in VAS scores （P〈0.05） . Conclusion The incidence of ED after general anesthesia in children remains high and ED can cause serious complications. Proper nursing care is very important in decreasing the complications and ensuring the safety of the operations.

关 键 词：全麻 小儿 苏醒期躁动 护理 

分 类 号：R473.72[医药卫生—护理学]