多模式围手术期处理对小儿人工耳蜗植入术后恢复的影响研究  

Effect of Multimodal Perioperative Management on Recovery after Cochlear Implantation in Children

作　　者：李苗苗 刘宁[1] LI Miaomiao;LIU Ning(Department of anesthesia and perioperative medicine,Henan Provincial People’s Hospital Zhengzhou Henan 450000,China)

机构地区：[1]河南省人民医院麻醉与围术期医学科,河南郑州450000

出　　处：《临床研究》2022年第11期163-166,共4页Clinical Research

摘　　要：目的探讨多模式围手术期处理对人工耳蜗植入术后患儿恢复的影响。方法纳入河南省人民医院2020年5月至2021年5月择期行人工耳蜗植入术的80例患儿为研究对象,经随机排列法将40例给予常规围手术期处理的患儿纳入对照组,其余40例给予多模式围手术期处理的患儿纳入研究组,比较两组患儿围手术期不同时间段的焦虑评分、手术时间、麻醉复苏时间、首次进食时间、麻醉苏醒期躁动、镇静评分以及术后24 h不良反应的差异。结果研究组患儿预备进入手术室时(T0)焦虑评分(7.49±1.35)分、到达手术室时(T1)焦虑评分(8.10±1.52)分、开放静脉通道时(T2)焦虑评分(7.96±1.38)分和麻醉诱导期(T3)焦虑评分(7.50±1.25)分,均依次低于对照组患儿(9.50±2.04)分、(11.42±2.08)分、(10.67±2.10)分、(9.54±1.82)分,差异有统计学意义(P<0.05)。两组患儿手术时间比较,差异无统计学意义(P>0.05);研究组患儿麻醉复苏时间(3.59±0.72)h和首次进食时间(3.99±1.25)h均短于对照组患儿(6.02±1.33)h、(6.82±1.40)h,差异有统计学意义(P<0.05)。研究组患儿躁动评分(7.60±1.22)分低于对照组患儿(13.85±1.52)分,镇静评分(2.09±0.54)分高于对照组患儿(3.76±0.55)分,差异有统计学意义(P<0.05)。研究组患儿不良反应发生率(7.50%)低于对照组患儿(25.00%),差异有统计学意义(P<0.05)。结论多模式围手术期处理可以有效缓解人工耳蜗植入术患儿围手术期的焦虑程度,缩短患儿麻醉复苏和进食时间,减少麻醉恢复期躁动的发生,保障良好镇静效果的同时更利于围术期的管理,降低不良反应发生率,促进患儿术后的恢复,临床应用效果显著。Objective To investigate the effect of multimodal perioperative management on the recovery after cochlear implantation in Children.Methods A total of 80 children who were scheduled to undergo cochlear implantation in Henan Provincial People’s Hospital from May 2020 to May 2021 were enrolled as the research objects.According to random arrangement,40 children who received routine perioperative management were included in the control group,and the other 40 children who received multimodal perioperative management were included in the study group.The perioperative anxiety score,operation time,anesthesia resuscitation time,first feeding time,anesthesia recovery agitation,sedation score and adverse reactions at 24 hours after operation were compared between the two groups.Results The anxiety score of the study group was(7.49±1.35)points when preparing to enter the operating room(T0),(8.10±1.52)points when arriving at the operating room(T1),(7.96±1.38)points when opening the venous access(T2),and(7.50±1.25)points during anesthesia induction(T3),were lower than those of the control group(9.50±2.04),(11.42±2.08),(10.67±2.10),(9.54±1.82)successively,the differences were statistically significant(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).The anesthetic resuscitation time(3.59±0.72)h and the first feeding time(3.99±1.25)h in the study group were shorter than those in the control group(6.02±1.33)h and(6.82±1.40)h,and the differences were statistically significant(P<0.05).The agitation score of the study group was(7.60±1.22)lower than that of the control group(13.85±1.52),and the sedation score was(2.09±0.54)higher than that of the control group(3.76±0.55),and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group(7.50%)was lower than that in the control group(25.00%),and the difference was statistically significant(P<0.05).Conclusion Multimodal perioperative management can effectively relieve the anxiety

关 键 词：多模式围手术期处理 人工耳蜗植入术 学龄前儿童 术后恢复 躁动 

分 类 号：R473.72[医药卫生—护理学]