积极心理干预对斜视手术全身麻醉后苏醒期患儿躁动发生率,心理状况的影响  

Effect of positive psychological intervention on the incidence of agitation and psychological status of children after general anesthesia after strabismus operation

作　　者：曹丽燕 施越青 钱敏 CAO Liyan;SHI Yueqing;QIAN Min(Zhangjiagang Traditional Chinese Medicine Hospital,Anesthesiology Department,Zhangjiagang 215600,China)

机构地区：[1]张家港市中医医院麻醉科,张家港215600

出　　处：《国际精神病学杂志》2024年第4期1247-1250,1261,共5页Journal Of International Psychiatry

基　　金：江苏省中医药局科技项目(编号:LZ13153)。

摘　　要：目的研究旨在了解积极心理干预在全身麻醉后苏醒期患儿中的应用效果及对躁动发生率,心理状况的影响。方法选择了2021年1月~2023年12月之间接受斜视手术的学龄前儿童患儿,共计160例。采用随机数字表法将病例随机分为两组,每组各80例。干预组接受围术期心理干预,使用儿童麻醉苏醒期躁动评分(Pediatric anesthesia emergence delirium,PAED)量表对两组患儿进行评估;焦虑、抑郁状态分别参照汉密顿焦虑量表(Hamilton Anxiety Scale,HAMA),汉密顿抑郁量表(Hamilton Depression Scale,HAMD)。结果术后PAED评分干预组明显低于对照组,差异有显著性意义(P<0.01)。干预组苏醒期躁动(EA)发生率显著少于对照组,差异有显著性意义(P<0.01)。术后监护室(PACU)滞留时间干预组少于对照组,差异有统计学意义(P<0.05)。治疗后研究组HAMA评分,HAMD评分较低(P<0.05)。研究组发生苏醒躁动8例,对照组发生苏醒躁动24例,研究组苏醒期躁动发生率10.00%,明显低于对照组30.00%(P=0.019)。结论接受围术期积极心理干预的患儿在术后苏醒期躁动方面表现更为良好,心理状况更佳;且围术期积极心理干预可以缩短PACU滞留时间,提高麻醉安全性,减少术后并发症。Objective To investigate the effect of positive psychological intervention on the incidence of agitation and psychological status of children after general anesthesia.Methods A total of 160 preschoolers who underwent surgery for strabismus between January 2021 and December 2023 were selected.The cases were randomly divided into two groups with 80 cases in each group by random number table method.The intervention group received perioperative psychological intervention,and Pediatric anesthesia emergence delirium(PAED)scale was used to evaluate the children in both groups.For Anxiety and Depression,refer to Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)respectively.Results The PAED score of the intervention group was significantly lower than that of the control group(P<0.01).The incidence of EA in the intervention group was significantly lower than that in the control group,and the difference was significant(P<0.01).The PACU retention time in the intervention group was less than that in the control group,and the difference was statistically significant(P<0.05).There HAMA and HAMD scores of the study group after treatment were lower(P<0.05).Waking agitation occurred in 8 cases in the study group and 24 cases in the control group.The incidence of waking agitation in the study group was 10.00%,which was significantly lower than that in the control group(P=0.019).Conclusion The children who received perioperative positive psychological intervention showed better agitation and better psychological status in postoperative recovery period.Perioperative positive psychological intervention can shorten PACU retention time,improve anesthesia safety and reduce postoperative complications.

关 键 词：心理干预 麻醉苏醒期躁动 儿童 

分 类 号：R749[医药卫生—神经病学与精神病学]