右美托咪定联合动画片对防治全麻下腹腔镜疝囊高位结扎术患儿术后不良行为改变的影响  

Effect of dexmedetomidine combined with animation intervention on postoperative adverse behavior changes in children undergoing laparoscopic high ligation of hernia sac under general anesthesia

作　　者：李媛媛[1] 张俊丽 尹静 杨鸿源[1] 白耀武[1] LI Yuanyuan;ZHANG Junli;YIN Jing(Department of Anesthesiology,Tangshan Municipal Maternity and Child Health Care Hospital,Hebei,Tangshan 063000,China)

机构地区：[1]河北省唐山市妇幼保健院麻醉科,063000

出　　处：《河北医药》2024年第7期1002-1005,共4页Hebei Medical Journal

基　　金：河北省卫健委研究课题计划项目(编号:20221749)。

摘　　要：目的研究右美托咪定联合动画片对防治全麻下腹腔镜疝囊高位结扎术患儿术后不良行为改变的影响。方法选择2020年2月至2022年2月于医院接受全麻下腹腔镜疝囊高位结扎术治疗的患儿120例。随机数字表分为A组、B组、C组,每组40例。A组予以右美托咪定联合动画片干预,B组予以右美托咪定干预,C组予以动画片干预。分析3组围术期焦虑、诱导期合作度、苏醒期躁动及术后不良行为改变等方面的差异。结果A组入手术室即刻、麻醉诱导前、术后12 h改良耶鲁围术期焦虑量表(mYPAS)评分分别为(52.19±11.46)分、(54.27±12.09)分、(40.60±7.68)分,均低于B组的(60.07±12.74)分、(65.92±13.45)分、(47.25±8.59)分以及C组的(59.74±12.30)分、(63.48±13.20)分、(46.15±8.11)分(均P<0.05)。A组入手术室即刻、麻醉诱导前诱导期合作度量表(ICC)评分分别为(3.35±0.70)分、(3.67±0.82)分,均低于B组的(4.22±1.09)分、(4.93±1.15)分及C组的(4.30±1.04)分、(4.62±1.26)分(均P<0.05)。A组最高苏醒期躁动评分(PAED)及离开PACU时PAED评分分别为(6.19±0.30)分、(4.21±0.25)分,均低于B组的(7.05±0.38)分、(5.41±0.28)分及C组的(7.07±0.39)分、(5.60±0.29)分(均P<0.05)。A组术后1 d、7 d、30 d不良行为发生率均低于B组、C组(均P<0.05)。结论右美托咪定联合动画片可有效改善全麻下腹腔镜疝囊高位结扎术患儿围术期焦虑、诱导期合作度、苏醒期躁动及术后不良行为改变,值得推广普及。Objective To study the effects of dexmedetomidine combined with animation intervention on postoperative adverse behavior changes in children undergoing laparoscopic high ligation of hernia sac under general anesthesia.Methods A total of 120 children who received laparoscopic high ligation of hernia sac under general anesthesia in hospital from February 2020 to February 2022 were enrolled.The patients were randomized 1∶1∶1 into group A(dexmedetomidine combined with animation intervention),group B(dexmedetomidine intervention)and group C(animation intervention).The differences of perioperative anxiety,the degree of cooperation during induction period,emergence agitation and postoperative adverse behavior changes among the three groups were analyzed.Results The modified Yale Perioperative Anxiety Scale(mYPAS)scores in group A were significantly lower than those of group B and group C(immediately after entering the operating room:(52.19±11.46)points vs(60.07±12.74)points vs(59.74±12.30)points;before anesthesia induction:(54.27±12.09)points vs 65.92±13.45 points vs 63.48±13.20 points;12h after surgery:(40.60±7.68)points vs(47.25±8.59)points vs 46.15±8.11 points,P<0.05).The induction compliance checklist(ICC)scores in group A were significantly lower than those of group B and group C(immediately after entering the operating room:(3.35±0.70)points vs(4.22±1.09)points vs(4.30±1.04)points;before anesthesia induction(3.67±0.82)points vs(4.93±1.15)points vs(4.62±1.26)points,P<0.05).The highest score of pediatric anesthesia emergence delirium(PAED)([6.19±0.30]points vs[7.05±0.38]points vs[7.07±0.39]points)and PAED score after leaving postanesthesia care unit(PACU)([4.21±0.25]points vs[5.41±0.28]points vs[5.60±0.29]points)in group A were significantly lower than those of group B and group C(P<0.05).The incidence of adverse behavior in group A was lower than that in group B and group C on day 1,7 and 30 after surgery(all P<0.05).Conclusion Dexmedetomidine combined with animation intervention can effect

关 键 词：腹腔镜疝囊高位结扎术 右美托咪定 动画片 不良行为改变 全麻 

分 类 号：R656.21[医药卫生—外科学]