不同心理特征对全麻患儿行为影响.docVIP

不同心理特征对全麻患儿行为影响 　【摘要】 目的 探讨不同心理特征的患儿术前焦虑水平、苏醒期躁动倾向及术后行为适应情况。方法 选择扁桃体和/或腺样体切除的患儿53例，ASAⅠ～Ⅱ，年龄5～12岁，全麻气管插管，静吸复合麻醉。术前于病房内进行艾森克个性问卷测试，根据情绪稳定性评分（N）将所有患儿分成两组：情绪不稳定组（C组：n=28）、 情绪稳定组（S组：n=25）。分别于术前1日病房内、手术室内麻醉诱导前对所有患儿用儿童情绪表现评分量表（CEMS）进行焦虑评分，于麻醉苏醒期、术后第1、2、3周分别用苏醒期躁动评分量表（PAED）、术后行为量表(PHBQ)进行苏醒期的意识状态和术后适应生活环境的状况给予评估。结果 两组患儿在病房内的焦虑评分对比无显著性差异（P＞0.05）。入室后， C组的焦虑评分及心率明显高于S组（P＜0.05）。麻醉恢复室内C组躁动评分明显高于S组（P＜0.05）。两组患儿均出现术后行为适应不良现象，第1周内C组患儿发生率较S组高 (P＜0.05），术后第2、3周二者对比无显著性差异（P＞0.05）。结论 患儿术前情绪的稳定性可以影响术前焦虑水平、苏醒期躁动发生和行为适应性。 　　【关键词】 麻醉； 儿童 ；心理特征； 焦虑； 躁动； 术后行为适应不良 　　 　　Influence of different personality traits on the behavior of children undergoing general anesthesia 　　【Abstract】 Objective Influence of different personality traits on the behavior of children undergoing general anesthesia.Methods Fifty-three children of ASAⅠ-Ⅱ,aged 5-12，undergoing elective adenotonsillectomy were divided into 2 groups based on the neuroticism of Eysenck Personality Questionnaire： Emotional instability (group C) and emotional stability(group S ). Items were tested：(1) Preoperative anxiety were evaluated by the Childrens Emotional Manifestation Scale(CEMS).(2) Emergence status measured by the Pediatric Anesthesia Emergence Delirium Scale. (3)Postoperative maladaptive behavioral response and negative behavioral changes evaluated by the Post Hospital Behavior Questionnaire(PHBQ).Results Compared with group S, Group C had higher scores of CEMS and PAED ，higher heart rate， and more postoperative new-onset maladaptive behavioral changes arising, especially in the first week after surgery.Conclusion The children with emotional instability are at high risk of developing these three clinical phenomena：preoperative anxiety，emergence delium and postoperative maladaptive behavior(obviously in the first postoperative week). 　　【Key words】 anesthesia; children; personality traits;anxiety; emergence delirium; postoperative maladaptive behavior 　　 　　对患儿来说，无论手术的大小，围术期常常是个极其创伤的时期；由于认知能力有限，自控能力差，医疗卫生知识的局限，在紧张的医疗氛围应激过程中，约