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| 术前面罩预适应不同实施者对患儿术前焦虑的影响 |
| Effect of different preoperative mask preconditioning implementers on preoperative anxiety in children |
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| DOI：10.12089/jca.2020.08.010 |
| 中文关键词: 术前焦虑 小儿 面罩 预适应 |
| 英文关键词: Preoperative anxiety Children Mask Preconditioning |
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| 中文摘要: |
目的 探讨术前面罩预适应对降低患儿术前焦虑的作用，并比较不同实施者的影响。
方法 纳入全麻下行腹腔镜疝囊修补或鞘状突高位结扎手术患儿105例，男81例，女24例，年龄2~7岁，BMI 18~23 kg/m2，ASA Ⅰ或Ⅱ级。患儿随机分为三组：术前1 d由父母对患儿实施面罩预适应组（P组，n=37），术前1 d由麻醉科医师对患儿实施面罩预适应组（A组，n=35），不实施面罩预适应组（C组，n=33）。采用改良耶鲁焦虑量表（mYPAS）分别于进入等待区（T0）、与父母分离进入手术室时（T1）、麻醉诱导时（T2）、麻醉苏醒时（T3）评估患儿焦虑程度，T2时采用诱导合作量表（ICC）和面罩接受度评分（MAS）评估患儿诱导时的依从性。
结果 与T0时比较，T1时三组mYPAS评分均明显升高(P＜0.05)。与T1时比较，T2时三组mYPAS评分明显升高(P＜0.05)。与T2时比较，T3时三组mYPAS评分明显降低(P＜0.05)。T1—T3时P组和A组mYPAS评分明显低于C组(P＜0.05)，T2时P组mYPAS评分明显低于A组(P＜0.05)。T2时P组和A组ICC评分明显低于C组，且P组明显低于A组[P组（3.6±1.6）分，A组（4.6±1.8）分，C组（5.5±1.8）分，P＜0.05]。T2时P组和A组MAS评分明显高于C组[P组（2.7±0.9）分，A组（2.8±0.8）分，C组（2.0±0.8）分，P<0.05]，而P组和A组差异无统计学意义。
结论 面罩预适应能有效降低患儿术前焦虑，由父母术前1 d实施更能有效减轻患儿诱导时焦虑。 |
| 英文摘要: |
Objective To investigate the effectiveness of mask preconditioning in reducing preoperative anxiety in children, with a specific focus on the effects of different implementers.
Methods A total of 105 children with laparoscopic hernia sac repair or sheath ligation under general anesthesia were included, 81 males and 24 females, aged 2-7 years, with a BMI 18.3-22.5 kg/m2, ASA physical status Ⅰ or Ⅱ, were randomly divided into parents directed mask exposure one day before surgery (group P), anesthesiologists directed mask exposure one day before surgery (group A), no exposure prior to induction (group C). The modified Yale preoperative anxiety scale (mYPAS) was used to evaluate the anxiety level of the children at four points: waiting area (T0), transfer to operating room (T1), anesthesia induction (T2), and anesthesia awakening (T3). The induction compliance checklist (ICC) and the mask acceptability score (MAS) were used to evaluate the mask acceptance at T2.
Results mYPAS scores of the three groups were significantly increased in turn, from T0 to T1, T2, and T3, there was a significant difference between any two time points (P < 0.05). The mYPAS scores of group P and group A were significantly lower than those of group C at T1, T2, and T3(P < 0.05), whereas the mYPAS scores of group P were significantly lower than those of group A at T2(P < 0.05). ICC scores of group P (3.6±1.6) and group A (4.6±1.8) were significantly lower than those in group C (5.5±1.8, P < 0.05), meanwhile ICC scores in group P were significantly lower than those in group A at T2(P < 0.05). MAS scores of group P (2.7±0.9) and group A (2.8±0.8) were significantly higher than those in group C (2.0±0.8， P < 0.05). There was no significant difference in the MAS scores between the group P and group A.
Conclusion Mask preconditioning can effectively reduce preoperative anxiety in children, and parents direct mask exposure one day before surgery can more effective to reduce anxiety during induction. |
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