达克罗宁胶浆气管导管涂抹用于小儿全麻围拔管期的临床效果观察  

The clinical effect of dyclonine mucilage coating on endotracheal tube to children under general anesthesia during peri-extubation period

作　　者：伍励 陈旭[1] 潘先凤 曾薇[1] WU Li;CHEN Xu;PAN Xian-feng;ZENG Wei(Depart- ment of Anesthesiology ,Sichuan Maternal and Child Health Hospital, Chengdu 610041, China)

机构地区：[1]四川省妇幼保健院麻醉科,四川成都610000

出　　处：《实用医院临床杂志》2018年第3期208-211,共4页Practical Journal of Clinical Medicine

摘　　要：目的观察达克罗宁胶浆涂抹气管导管对小儿扁桃体手术全麻围拔管期的临床效果。方法择期行扁桃体摘除术患儿60例,年龄3~8岁,采用随机数字表法分为试验组和对照组各30例,试验组气管导管前段用达克罗宁胶浆涂抹,对照组不涂抹任何药物,两组麻醉方法相同。观察两组患儿手术结束时(T1),拔管即刻时(T2),拔管后5分钟时(T3)、拔管后10分钟时(T4)的平均动脉压(mean arterial pressure,MAP)、脉搏变化,拔管后憋气、呛咳等不良反应,苏醒期躁动评分,儿童术后疼痛评分及两组患者家属的满意度。结果术后T2、T3、T4时点试验组患儿心率和血压明显低于对照组,拔管后呛咳及憋气程度轻于对照组,苏醒期躁动发生情况轻于对照组,家长满意度明显高于对照组,差异有统计学意义(P<0.05)。结论达克罗宁胶浆涂抹气管导管可安全用于小儿扁桃体手术,维持更稳定的血流动力学状态,减少患儿苏醒期的躁动,降低拔管导致的不良反应,提高家长的满意度。Objective To observe the clinical effect of dyclonine mucilage to endotracheal tube for pediatric adenotonsillectomy under general anesthesia during peri-extubation period.Methods Sixty patients（ 3-8 year old） with adenotonsillectomy were randomly divided into experimental（ dyclonine coating） and control（ non-dyclonine coating） groups,30 in each group.General anesthesia was performed for the both groups.The mean arterial pressure（ MAP） and heart rate（ HR） at T1（ the end of the operation）,T2（ the moment of endotracheal extubation）,T3（ 5 min after endotracheal extubation） and T4（ 10 min after endotracheal extubation） were recorded.The incidence of choking,bucking,emergence agitation grading（ PEAD score） and CHIPPS（ children post-operation pain score） after endotracheal extubation were observed.Satisfaction of parents was surveyed.Results The HR and MAP at T2,T3 and T4,incidence of choking and bucking,PEAD score and CHIPPS after endotracheal extubation in the experimental group were significantly lower than those in the control group（ P〈0. 05）.The Parents＇ satisfaction in the experimental group was higher than that in the control group（ P〈0. 05）.Conclusion Dyclonine hydrochloride for endotracheal intubation is safe. The application of dyclonine before endotracheal intubation in children adenotonsillectomy under general anesthesia can maintain stable hemodynamics,reduce the incidence of choking,bucking and emergence agitation,and improve the satisfactions of patients＇ parents.

关 键 词：盐酸达克罗宁胶浆 全麻 气管导管 苏醒期躁动 围拔管期护理 麻醉专科护士 

分 类 号：R473[医药卫生—护理学]