护理干预联合右旋美托咪定预防阻塞性睡眠呼吸暂停综合征手术患儿苏醒期躁动的效果  

Study on the effect of nursing intervention combined with dexmedetomidine to prevent restlessness during recovery period in children with obstructive sleep apnea hypopnea syndrome

作　　者：费娟 严佳[1] 施瑱[1] FEI Juan;YAN Jia;SHI Zhen(Department of Anesthesiology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科

出　　处：《中国口腔颌面外科杂志》2019年第5期457-461,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨护理干预联合右旋美托咪定对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)手术患儿苏醒期躁动及苏醒时间的影响。方法:将120例3~6岁择期行腭垂腭咽成形术手术的OSAHS患儿随机等分为实验组和对照组,每组各60例。对照组进行全身麻醉手术,实验组在对照组用药处理基础上,使用右旋美托咪定和护理进行联合干预,比较2组患儿进入手术室时(T0)、气管插管拔除时(T1)的心率(HR)和脉搏氧饱和度(SpO2),拔管时间、苏醒时间、苏醒期躁动及不良反应发生率。采用SPSS 22.0软件包中的t检验和χ2检验对数据进行统计学处理。结果:2组患儿T0时HR及SpO2无显著差异(P>0.05)。2组患儿T1时SpO2显著低于T0时(P<0.05);对照组患儿T1时HR显著高于T0时(P<0.05);实验组患儿T0、T1时HR比较,差异无统计学意义(P>0.05)。T1时实验组患儿HR显著低于对照组(P<0.05),2组患儿SpO2比较差异无统计学意义(P>0.05)。对照组与实验组的拔管时间、苏醒时间比较差异无统计学意义(P>0.05)。实验组患者苏醒期躁动发生率显著低于对照组(P<0.05)。实验组患儿苏醒期不良反应发生率(5%)均显著低于对照组(20%)。结论:护理干预联合右旋美托咪定对于防治OSAHS患儿全麻苏醒期躁动,切实提高麻醉安全具有重要作用。PURPOSE:To explore the effect of nursing intervention combined with dexmedetomidine on restlessness and recovery time of children with obstructive sleep apnea hypopnea syndrome(OSAHS)during recovery period.METHODS:One hundred and twenty OSAHS patients who underwent elective uvulopalatopharyngoplasty from Nov.2016 to Nov.2018 were selected as the study subjects.They were randomly divided into experiments'group and control group equally.Patients in the control group underwent general anesthesia,and patients in the experimental group were treated with dexmedetomidine and nursing on the basis of the treatment of the control group.HR and SpO2,intubation time,wake time,awakening period and adverse reactions in the two groups were compared when they entered the operating room(T0)and extract of tracheal intubation(T1)with SPSS 22.0 software package.RESULTS:There was no significant difference in HR and SpO2 between the two groups(P>0.05)at T0.SpO2was significantly lower than T0 at T1 in both groups(P<0.05);HR was significantly higher than T0 at T1(P<0.05)in the control group,there was no significant difference in HR between T0 and T1 in the experimental group(P>0.05).HR of the experimental group was significantly lower than that of the control group at T1(P<0.05);there was no significant difference in SpO2 between the two groups at T1(P>0.05),and no significant difference in extubation time and recovery time between the two groups(P>0.05).The incidence of agitation in the experimental group was significantly lower than that in the control group(P<0.05).The incidence of adverse reactions in the experimental group was significantly lower than that in the control group(P<0.05).CONCLUSIONS:Nursing intervention combined with dexmedetomidine is important for prevention and treatment of restlessness during recovery time in children with OSAHS,which can improve the safety of general anesthesia.

关 键 词：右旋美托咪定 护理干预 苏醒期躁动 阻塞性睡眠呼吸暂停低通气综合征 

分 类 号：R782.05[医药卫生—口腔医学]