全麻行肝叶切除术患者麻醉恢复期躁动的影响因素分析及护理对策  

The factors analysis of general anesthesia in patients undergoing hepatectomy narcotic and nursing intervention effect of agitation during recovery

作　　者：钱淑英[1] 胡礼宏[1] 顾培君 

机构地区：[1]宁波市医疗中心李惠利医院麻醉科,浙江宁波315041 [2]宁波市北仑区中医院,浙江宁波315800

出　　处：《中国现代医生》2015年第6期151-153,共3页China Modern Doctor

基　　金：浙江省宁波市医学科技计划项目(2013A01)

摘　　要：目的分析全麻行肝叶切除术患者麻醉恢复期躁动的影响因素分析,并采取对应的护理对策。方法 50例肝叶切除术患者术后进入麻醉恢复室(PACU)发生躁动10例,躁动发生率达20%,设立为躁动组,其余40例为未发生躁动组。10例躁动中,轻度5例,中度3例,重度2例。比较两组躁动的影响因素,并采取对应的护理措施。结果全麻行肝叶切除术患者麻醉恢复期躁动的发生与患者的年龄、性别、术后镇痛、催醒药物的使用及麻醉方法、拔管时机、并发症密切相关(P<0.05)。对上述单因素进行Logistic回归分析,结果显示:术后使用镇痛药(OR=3.253)、使用催醒药(OR=4.128)及麻醉方法 (OR=2.876)为全麻行肝叶切除术患者麻醉恢复期躁动的影响因素。结论全麻肝叶切除术患者麻醉苏醒期躁动由多种原因引起,应根据病情对症处理,同时采取有效的护理措施,以保证患者平稳地度过苏醒期。Objective To analyze the influencing factors of general anesthesia in patients undergoing hepatectomy anesthesia agitation during recovery analysis, and to take corresponding nursing intervention. Methods A total of 50 cases of hepatectomy patients in anesthesia recovery room（PACU） occurred in 10 cases,the incidence of agitation rate was 20%,set for the agitation group, and 40 cases without agitation set up agitation group. In 10 cases of agitation, 5 cases mild, 3 cases moderate,2 cases severe. The agitation influencing factors were compared between two groups and to take corresponding nursing measures. Results The general anesthesia in patients undergoing hepatectomy anesthesia recovery occurred and the patient＇s age, gender, operative analgesia, urge the agitation of using drugs and methods of anesthesia,awake extubation time,complications were closely related（P〈0.05）. Logistic regression analysis of single factor,the results showed：the use of analgesics after surgery（OR=3.253） and using analeptic（OR=4.128） and anesthesia method（OR=2.876） for general anesthesia in patients undergoing hepatectomy anesthesia influencing factors of agitation during recovery. Conclusion General anesthesia in patients undergoing hepatectomy emergence agitation caused by many reasons, should according to the condition of symptomatic treatment, at the same time effective nursing measures, so as to ensure the patients smoothly through the recovery period.

关 键 词：肝叶切除术 全麻 麻醉恢复期 躁动 影响因素 护理干预 

分 类 号：R473.6[医药卫生—护理学]