适应性训练对学龄期患儿眼科术后黑暗恐惧的改善效果  

Effect of adaptive training on fear of dark after eye surgery in school-aged children

作　　者：鹿微 郭桂贤 李牧丹 冯慧萍 王丽强[1] LU Wei;GUO Guixian;LI Mudan;FENG Huiping;WANG Liqiang(Department of Orbital Surgery,Senior Department of Ophthalmology,the Third Medical Center,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心眼科医学部眼眶病外科,北京100039

出　　处：《解放军医学院学报》2022年第10期1075-1078,共4页Academic Journal of Chinese PLA Medical School

摘　　要：背景患儿眼科术后多需包扎单眼或双眼,导致其因处于黑暗中而内心产生恐惧心理。学龄期手术患儿(6~12岁)的黑暗恐惧反应较其他年龄段患儿更严重。目前对患儿术后的黑暗恐惧缺乏科学的干预方法。目的研究适应性训练对学龄期患儿眼科术后黑暗恐惧的改善效果。方法选取2019年12月-2021年12月于我中心眼科住院行眼外肌手术的学龄期儿童,随机分为对照组和适应性训练组,对照组给予常规术前健康宣教及心理护理;适应性训练组在术前1 d指导患儿进行黑暗环境感受、3 m往返游戏、术后场景模拟训练。两组均给予全麻术后护理常规、吸氧6 h和心电监护,观察生命体征。观察两组患儿术后5 min躁动的发生率和程度[用镇静-躁动评分量表(sedation-agitation scale,SAS)进行评估],以及两组术后10 min、20 min心率。结果共选取106例患儿。对照组53例,男性26例,女性27例,年龄7~12(9.16±2.12)岁;适应性训练组53例,男性24例,女性29例,年龄6~11(8.91±2.14)岁。两组年龄、性别等一般情况差异无统计学意义(P>0.05)。术前两组心率及躁动发生率差异无统计学意义(P>0.05)。术后对照组躁动发生率为83.01%,适应性训练组躁动发生率为28.30%,两组差异有统计学意义(P<0.05)。对照组术后10 min心率[(101.6±10.8)/min vs(92.8±10.3)/min]、20 min心率[(95.5±9.4)/min vs(83.3±9.3)/min]高于适应性训练组,两组差异有统计学意义(P均<0.05)。结论适应性训练能明显缓解学龄期患儿眼科术后黑暗恐惧,效果明显,患儿易于接受。Background Children need to bandage one or both eyes after ophthalmic surgery,resulting in rising of fear due to being in the dark.The fear of the dark in school-aged children(6-12 years)is more serious than children of other ages.At present,there is a lack of scientific intervention methods for fear of the dark in children.Objective To investigate the effectiveness of adaptive training on fear of the dark in school-aged children postoperatively.Methods From December 2019 to December 2021,school-aged children who underwent extraocular muscle surgery were selected from the Department of Ophthalmology,and they were divided into the control group and the adaptive training group randomly,the control group was given routine preoperative health education and psychological care;while the adaptive training group was given dark environment feeling training,3-meter round-trip game,and postoperative scene simulation on the day before surgery,and both groups were given normal nursing routine after general anesthesia surgery,including oxygen inhalation for 6h and ECG monitoring to observe vital signs.At last,the incidence and extent of postoperative agitation assessed by the Sedation-Agitation Scale(SAS)at 5 min after surgery,and the heart rate at 10min and 20min postoperative in both groups were observed.Results A total of 106 children were enrolled,and 53 children were assigned to the control group,including 26 males and 27 females,aged 7-12(9.16±2.12)years;53 cases in adaptive training group,including 24 males and 29 females,aged 6-11(8.91±2.14)years.There was no significant difference in age,gender and other general conditions between the two groups(P>0.05).There was no significant difference in the incidence of agitation before operation.After operation,the incidence of agitation in the control group was 83.01%,and it was 28.30%in the adaptive training group,with statistically significant difference(P<0.05).The heart rate at 10min and 20min in the control group were([101.6±10.8]/min vs[92.8±10.3]/min)and([95.5±9.4]/

关 键 词：适应性训练 黑暗恐惧 学龄期患儿 眼科术后 镇静-躁动评分量表 

分 类 号：R779.6[医药卫生—眼科]