郑娅启 张美雪 李碧莲

[摘要] 目的 調查阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿围术期心理状况，探讨动漫视频对其干预的效果，减少OSAHS患儿围术期焦虑的发生。 方法 选择2019年6～8月在广州妇女儿童医疗中心耳鼻咽喉科进行OSAHS手术治疗的60例患儿作为研究对象，依据随机数字表法将其分为实验组和对照组，每组30例。实验组采用自主研发的动漫视频进行术前宣教，对照组采用常规术前宣教方法宣教。比较两组术前1 d（干预前）、麻醉诱导前3 min（干预后）的焦虑评分。比较两组麻醉诱导配合度评分，家属满意度评分及干预前、麻醉诱导后、术后恢复室拔管前（苏醒期）的唾液皮质醇水平。 结果 干预前两组焦虑评分比较，差异无统计学意义（P > 0.05）;干预后实验组焦虑评分低于对照组（P < 0.05）。实验组ICC评分低于对照组（P < 0.05）。实验组家属满意度评分高于对照组（P < 0.05）。实验组麻醉诱导后、苏醒期唾液皮质醇水平低于对照组（P < 0.05）。 结论 OSAHS患儿围术期焦虑情绪发生率高，动漫视频能明显减少OSAHS患儿围术期焦虑发生，减少围术期并发症，有利于患儿快速康复，值得推广。

[关键词] 儿童;阻塞性睡眠呼吸暂停低通气综合征;围术期;动漫;唾液皮质醇

[中图分类号] R473.71          [文献标识码] A          [文章编号] 1673-7210（2020）07（a）-0179-04

[Abstract] Objective To investigate the perioperative psychological status of children with obstructive sleep apnea hypopnea syndrome （OSAHS） and explore the effect of animation video， so as to reduce the occurrence of perioperative anxiety. Methods A total of 60 children who underwent OSAHS surgery in Department of Otolaryngology， Guangzhou Women and Children′s Medical Center from June to August 2019 were selected as objects. They were divided into the experimental group and the control group according to random number table method， with 30 cases in each group. The experimental group was received preoperative education with self-developed animation video， and the control group was received routine preoperative education. The anxiety scores of the two groups were compared on 1 d before operation （before intervention） and 3 min before anesthesia induction （after intervention）. Anesthesia induction coordination degree scores， family satisfaction degree and salivary cortisol levels before intervention， after anesthesia induction and before postoperative recovery of ventricular extubation （wake period） were compared between the two groups. Results There was no significant difference in anxiety score between the two groups before intervention （P > 0.05）. After intervention， the increased anxiety scores of the experimental group were lower than those of the control group （P < 0.05）. The ICC scores in the experimental group were lower than those in the control group （P < 0.05）. Family satisfaction degree scores in the experimental group were higher than those in the control group （P < 0.05）. The levels of salivary cortisol in the experimental group after anesthesia induction and wake period were lower than those in the control group （P < 0.05）. Conclusion The OSAHS children have high incidence of perioperative anxiety. Animation video can significantly reduce the incidence of perioperative anxiety in children with OSAHS and reduce perioperative complications， which is beneficial to the rapid recovery of patients.

[Key words] Children; Obstructive sleep apnea hypopnea syndrome; Perioperative period; Animation; Salivary cortisol

阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）是儿童最常见的睡眠障碍性疾病，其发病率为2%～5%，近年来呈不断上升趋势[1]。相关研究显示，OSAHS不但会造成患儿的生长发育迟缓，还可导致心肺功能损害以及认知功能障碍等危害[2]。腺样体/扁桃体肥大被认为是OSAHS患儿的主要病因，而且，腺样体/扁桃体切除术是目前OSAHS患儿的一线治疗方案[3]。据文献报道，50%～70%的OSAHS患儿围术期会出现焦虑症状，严重影响患儿伤口愈合等术后恢复，甚至会引起夜尿、胆怯、行为异常等后遗症[4]，但目前仍缺乏有效的减轻OSAHS患儿围术期焦虑的方法。由于……