天津护理 ›› 2023, Vol. 31 ›› Issue (1): 1-4.DOI: 10.3969/j.issn.1006-9143.2023.01.001

• 论著 •    下一篇

梧桐护理模式父母陪伴麻醉诱导对肝穿刺活检患儿诱导合作度及苏醒期谵妄的影响

李良玉 李胜卫 杨莉莉 陈彩虹 刘春英   

  1. (天津市第一中心医院,天津 300192)
  • 出版日期:2023-02-28 发布日期:2023-03-08

The effects of parent presence in the induction of anesthesia based on Wutong nursing model on the degree of cooperation and delirium during awakening period in children undergoing liver biopsy

LI Liangyu, LI Shengwei, YANG Lili, CHEN Caihong, LIU Chunying   

  1. (Tianjin First Central Hospital, Tianjin 300192)
  • Online:2023-02-28 Published:2023-03-08
  • Supported by:
    天津市科技计划项目(21JCYBJC00160);天津市 护理学会科研课题(tjhlky2021YB05)

摘要: 目的:探讨梧桐护理模式下父母陪伴麻醉诱导(parent presence at the induction of anesthesia, PPIA)对行肝穿刺活检术的肝移植状态患儿麻醉诱导期合作度及苏醒期谵妄(Emergence Delirium,ED)的影响。 方法:采用随机数字表法,将 2021 年 9月至 2022 年 3 月在全身麻醉下进行肝穿刺活检术的肝移植状态患儿 124 例分为对照组和观察组各 62 例。 对照组给予常规护理模式下父母陪伴麻醉诱导,观察组行梧桐护理模式下父母陪伴麻醉诱导。 比较两组患儿在麻醉诱导时、苏醒时、术后 1 h 的平均动脉压、心率变化。 采用麻醉诱导期合作程度量表 (Induction Checklist Compliance, ICC) 比较两组患儿麻醉诱导时合作程度, 采用苏醒期谵妄量表(Pediatric Anesthesia Emergence Delirium scale,PAED)比较两组患儿苏醒时、术后 1 h、术后 6 h、术后 12 h 谵妄评分及谵妄发生率。 结果:两组患儿各时间点平均动脉压、心率组间比较差异无统计学意义(P>0.05);观察组患儿诱导时 ICC 评分低于对照组,苏醒时及术后 1 hPAED 评分均低于对照组,差异有统计学意义(P<0.05);两组患儿术后 6 h、12 h PAED 评分比较差异无统计学意义(P>0.05);观察组总体谵妄发生率低于对照组,差异有统计学意义(P<0.05)。 结论:梧桐护理模式下父母陪伴麻醉诱导可提高肝移植后肝穿刺活检患 儿麻醉诱导期合作程度,降低苏醒期谵妄发生率,对于加速患儿康复,提高患儿围手术期安全具有积极意义。

关键词: 梧桐护理模式, 麻醉诱导, 谵妄, 肝穿刺活检术

Abstract:

Objective: To explore the effects of parent presence in the induction of anesthesia(PPIA)based on Wutong nursing
model on the cooperation during anesthesia induction and emergence delirium in children undergoing liver biopsy.
Methods: A total of 124 children with liver transplantation who underwent percutaneous liver biopsy from September 2021 to March 2022 were enrolled. Children were divided into two groups: control group(62 cases undergoing PPIA based on routine
nursing mode)and observation group (62 cases undergoing PPIA based on Wutong nursing model) using the random number table method. The changes of mean arterial pressure and heart rate at anesthesia induction(T0), awaking time(T1), 1 h(T2) after operation were compared between the two groups. ICC scale was used to evaluate the degree of cooperation during anesthesia induction(T0). Postoperative delirium was evaluated and compared at awaking time (T1), 1 h(T2), 6 h (T3), and 12 h (T4) after operation using PAED. The incidence of delirium was compared between the two groups.Results: There were no significant differences in mean arterial pressure and heart rate between the two groups at each time point(P >0.05). The ICC score at T0 time of induction in the observation group was significantly lower than that in the control group. The PAED scores at T1 and T2 time were significantly lower than those in the control group (P<0.05). There were no significant differences in PAED scores between the two groups at 6 h and 12 h after operation (P>0.05). The incidence of delirium in the observation group was significantly lower than the control group (P<0.05). Conclusion: PPIA based on Wutong nursing model can improve the degree of cooperation during anesthesia induction and reduce the incidence of delirium in awakening period in children undergong liver biopsy after liver transplantation. It is effective to accelerate the rehabilitation of children and improve the safety and comfort of children during perioperative period.

Key words: Wutong nursing model, Induction of anesthesia;Emergence delirium, Liver biopsy