优质麻醉苏醒护理对肩关节镜术后全麻复苏期患者躁动的影响  

Effects of High-Quality Nursing on Emergence Agitation of Patients in Resuscitation Period after General-Anesthesia Shoulder Arthroscopy

作　　者：肖蕊[1] 史晓萍[1] 高昀 张頔[2] 郑峒 王庚[1] Xiao Rui;Shi Xiaoping;Gao Yun;Zhang Di;Zheng Tong;Wang Geng(Anesthesiology Department,Beijing Jishuitan Hospital,Beijing 100035,China;Operating Theater,Beijing Jishuitan Hospital,Beijing 100035,China;Sports Medicine Service,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院麻醉科,北京100035 [2]北京积水潭医院手术室,北京100035 [3]北京积水潭医院运动损伤科,北京100035

出　　处：《中国运动医学杂志》2021年第10期777-783,共7页Chinese Journal of Sports Medicine

基　　金：北京积水潭医院院级科研基金——青年基金(QN-202102)。

摘　　要：目的:探究在肩关节镜术后全身麻醉复苏期采用优质护理干预对减少患者复苏期躁动(EA)的临床效果及其影响因素。方法:选取2020年10月至2021年4月在全身麻醉下行肩关节镜下肩袖修复手术的患者100例,并随机分为两组,对照组50例实施麻醉复苏期的基础护理,观察组50例在此基础上采取优质护理干预。根据Richmond量表记录患者EA评分。比较两组拔管时间、苏醒时间、复苏期低体温、复苏期寒战和EA的差异,通过多元Logistic回归分析观察组发生EA的危险因素。结果:观察组EA的发生率和评分分别为22%和0(0,0)分[M(P25,P75)],低于对照组的64%和1(0,2)分[M(P25,P75)](P<0.05)。观察组的拔管时间、苏醒时间、复苏期低体温发生率和复苏期寒战发生率均小于对照组(P<0.05)。观察组发生EA的独立危险因素为男性(OR=8.763,P=0.025)和复苏期低体温(OR=7.006,P=0.030)。结论:全身麻醉复苏期的优质护理干预能够降低肩关节镜术后患者复苏期躁动的发生率,男性和复苏期低体温是采取优质护理干预下仍然发生复苏期躁动的独立危险因素。Objective To explore the effect of high-quality nursing on reducing emergence agitation(EA) of patients in the resuscitation period after the general-anesthesia shoulder arthroscopy and to determine the influencing factors associated with EA.Methods Between October 2020 and April 2021,100 patients undergoing the shoulder arthroscopic rotator cuff repair in general anesthesia were randomly divided into an observation group and a control group,each of 50.Both groups were given routine nursing,while the observation group was additionally provided with high-quality nursing.The severity of EA was evaluated using the Richmond agitation-sedation scale.The time to extubation and to resuscitation,as well as the incidence of hypothermia,shivering and EA were compared between the two groups.The multivariate logistic regression analysis was used to identify the risk factors of EA in the observation group.Results The observation group had an EA incidence of 22% and Richmond score of0(0,0) [M(P25,P75)],significantly lower than the control group(P<0.05).Moreover,the average time to extubation and to resuscitation of the observation group were significantly earlier than the control group,while the average incidence of hypothermia and shivering were significantly lower than the latter group(P<0.05).The independent risk factors of EA in the observation group were male(OR=8.763,P=0.025) and hypothermia(OR=7.006,P=0.030).Conclusion High-quality nursing can lower the incidence of EA after the general-anesthesia shoulder arthroscopy,and male and hypothermia are two independent risk factors for the occurrence of EA.

关 键 词：复苏期躁动 麻醉后护理 肩关节 关节镜 围手术期 

分 类 号：R473.6[医药卫生—护理学]