CAJ | 학술논문

目的：探讨婴幼儿术中应用异丙酚复合瑞芬太尼麻醉后恢复期的疗效及护理体会。方法将全身麻醉下行择期手术的患儿710例随机分为试验组360例和对照组350例。试验组麻醉后予以生命体征管理、呼吸道护理、躁动及误吸护理等，对照组予以一般术后护理。结果试验组的呼吸恢复时间、意识恢复时间、拔管时间和离开恢复室时间分别为（9.78±1.25）min，（13.27±2.54）min，（16.80±3.29）min，（54.16±10.32）min，均显著短于对照组的（11.19±1.63）min，（17.36±3.57）min，（23.55±3.64）min，（59.81±11.26）min （ P<0.01）。两组患儿T2～T6的心率均显著高于T1，氧饱和度均显著低于T1（ P<0.05）；试验组T2～T6的平均动脉压和心率均显著低于对照组（ P<0.05）。两组患儿T4～T6的苏醒期躁动评分（RS）显著高于T3，镇静评分（RSS）显著低于T3（ P<0.05）；试验组T3～T6的 RS显著低于对照组，RSS显著高于对照组（ P<0.05）。试验组麻醉后恢复期并发症发生率为28.89%，显著低于对照组的37.14%（χ2=32.3685，P<0.01）。结论加强麻醉后恢复期护理和监护可以稳定患儿的生命体征，促进其苏醒，避免躁动发生，降低术后麻醉并发症发生率。
목적：탐토영유인술중응용이병분복합서분태니마취후회복기적료효급호리체회。방법장전신마취하행택기수술적환인710례수궤분위시험조360례화대조조350례。시험조마취후여이생명체정관리、호흡도호리、조동급오흡호리등，대조조여이일반술후호리。결과시험조적호흡회복시간、의식회복시간、발관시간화리개회복실시간분별위（9.78±1.25）min，（13.27±2.54）min，（16.80±3.29）min，（54.16±10.32）min，균현저단우대조조적（11.19±1.63）min，（17.36±3.57）min，（23.55±3.64）min，（59.81±11.26）min （ P<0.01）。량조환인T2～T6적심솔균현저고우T1，양포화도균현저저우T1（ P<0.05）；시험조T2～T6적평균동맥압화심솔균현저저우대조조（ P<0.05）。량조환인T4～T6적소성기조동평분（RS）현저고우T3，진정평분（RSS）현저저우T3（ P<0.05）；시험조T3～T6적 RS현저저우대조조，RSS현저고우대조조（ P<0.05）。시험조마취후회복기병발증발생솔위28.89%，현저저우대조조적37.14%（χ2=32.3685，P<0.01）。결론가강마취후회복기호리화감호가이은정환인적생명체정，촉진기소성，피면조동발생，강저술후마취병발증발생솔。
Objective To investigate the nursing experience during the recovery period in infantile intraoperative remifentanil combined with propofol anesthesia. Methods 710 children patients undergoing elective operation under general anesthesia in our department dur-ing 2012-2013 were selected and randomly divided into the experimental group ( n=360 ) and control group ( n=350 ) . The experimen-tal group was given the vital signs management, respiratory tract nursing, restlessness and aspiration nursing after anesthesia;the control group received the ordinary postoperative nursing. The postoperative recovery time, changes of vital signs at different time points, restless-ness score and sedation score and incidence rate of complications during the recovery period after anesthesia were compared between the two groups. Results The breathing recovery time, consciousness recovery time, extubation time and time leaving the recovery room in the experimental group were ( 9. 78 ± 1. 25 ) min, ( 13. 27 ± 2. 54 ) min, ( 16. 80 ± 3. 29 ) min and ( 54. 16 ± 10. 32 ) min respectively, which significantly shorter than ( 11. 19 ± 1. 63 ) min, ( 17. 36 ± 3. 57 ) min, ( 23. 55 ± 3. 64 ) min and ( 59. 81 ± 11. 26 ) min in the control group respectively ( P < 0. 01 ) . The heart rate ( HR ) at T2-T6 in the two groups were significantly higher than that at 10 min before the end of surgery, SpO2 was significantly lower than that at 10 min before the end of surgery ( P < 0. 05 );MAP and HR at T2-T6 in the ex-perimental group were significantly lower than those in the control group ( P < 0. 05 ) . RS at T4-T6 was significantly higher than that at T3, while RSS was significantly lower than that at T3 ( P < 0. 05 );RS at T3-T6 in the experimental group was significantly lower than that in the control group, while RSS was significantly higher than that in the control group ( P < 0. 05 ) . The incidence rate of complications during recovery period after anesthesia in the experimental group was 28. 89% , which was significantly lower than 37. 14% in the control group (χ2=32. 368 5, P < 0. 01 ) . Conclusion Strengthening the nursing and monitoring during the recovery pe-riod after anesthesia can stabilize the vital signs of the children patients, promotes them to waken, avoids the restlessness occurrence and reduces the incidence rate of postoperative anesthetic complications.