不同遮眼训练时长对学龄前期儿童全麻眼部术后急性谵妄的影响  

Effects of different lengths of time for covering the eyes before the surgery on emergence delirium in preschool-aged children undergoing general anesthesia for ophthalmic surgery

作　　者：董佩芳[1] 乔丹妮 陈惠莲[1] 陆水花 瞿少红[1] 赵迪 吴云涛 Dong Peifang;Qiao Danni;Chen Huilian;Lu Shuihua;Qu Shaohong;Zhao Di;Wu Yuntao(Ophthalmic Center,The Second Hospital of Medical College of Zhejiang University,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院眼科中心,浙江杭州310009

出　　处：《护理学杂志》2022年第9期34-37,共4页Journal of Nursing Science

基　　金：浙江省卫生健康科技计划项目(2021KY715)。

摘　　要：目的探讨术前遮眼训练时长对学龄前期儿童全麻眼部术后急性谵妄的影响。方法采用前瞻性研究,选取择期全麻眼部手术的学龄前期儿童为研究对象,其中一个单元患儿在动画视频宣教基础上结合术前遮眼训练,记录患儿遮眼时长;另一单元患儿术前采用动画视频宣教而不作遮眼训练为对照组。采用改良耶鲁评分量表(m-YPAS)、护理谵妄筛查量表(NU-DESC)、Wong-Baker面部表情疼痛量表及术后护理照护难度评分进行效果评价。结果完成遮眼训练的低时长(30~89 min)组189例,中时长(90~179 min)组133例,高时长(≥180 min)组72例,对照组146例。遮眼组术后急性谵妄发生率及m-YPAS评分、NU-DESC评分、护理照护难度评分显著低于对照组(均P<0.01);不同时长遮眼组间比较,差异无统计学意义(P>0.05,P>0.0083)。结论术前遮眼训练能降低学龄前期患儿全麻眼科术后急性谵妄发生率,低中等遮眼训练时长与高时长效果相当。Objective To explore the effects of different lengths of time for visual preconditioning(application of an eyepatch over the eye to be operated the day before surgery)on emergence delirium after ophthalmic surgery under general anesthesia in preschool-aged children.Methods A prospective study was conducted.Preschool-aged children undergoing elective ophthalmic surgery with general anesthesia were recruited.Children in one unit received visual preconditioning after video education,while their counterparts in the other unit only watched video for health education(control group).The Modified Yale Preoperative Anxiety Scale,Nursing Delirium Screening Scale,Wong-Baker Faces Pain Rating Scale and Postoperative Nursing Difficulty Score were utilized to measure the effects.Results Totally,189 children completed visual preconditioning for 30-89 min,133 for 90-179 min,and 72 for≥180 min.Compared with the control group(n=146),the visual preconditioning groups had significantly lower incidence of emergence delirium,and also lower scores of m-YPAS,NU-DESC and nursing difficulty(P<0.01 for all).There were no significant diffe-rences among the visual preconditioning groups(P>0.05,P>0.0083).Conclusion Prophylactic eyepatch treatment can reduce emergence delirium in preschool children undergoing general anesthesia for ophthalmic surgery.Visual preconditioning for 30-179 min is as effective as≥180 min.

关 键 词：学龄前期儿童 眼科手术 急性谵妄 遮眼训练 焦虑 疼痛 照护难度 

分 类 号：R473.77[医药卫生—护理学]