摘要
目的分析学龄期儿童斜视手术后阿片类药物镇痛需求的影响因素。方法回顾性分析2022年7月至2023年2月于浙江大学医学院附属第二医院眼科中心择期行斜视手术的120例患儿。根据患儿术后阿片类药物镇痛需求分为需求组(n=43)和非需求组(n=77)。采用单因素分析以及logistic多因素回归分析患儿的年龄、性别、居住地、父母受教育程度、家庭人均月收入、体重指数(BMI)、术前疼痛程度、术前是否使用阿片药物、术前焦虑自评量表(SAS)、抑郁自评量表(SDS)、自我效能感量表(GSES)、术后收缩压、术后舒张压对学龄期儿童斜视手术后阿片类药物镇痛需求的影响。结果单因素分析结果显示,术后需求组与非需求组的性别、SAS、SDS及GSES比较,差异有统计学意义(P<0.05)。多因素分析结果显示,女性(β=0.900,OR=2.460,95%CI:1.137~5.322)、高SAS(β=0.350,OR=1.418,95%CI:1.102~1.825)、高SDS(β=0.123,OR=1.131,95%CI:1.023~1.250)是影响术后阿片类药物镇痛需求的危险因素(P<0.05);高GSES(β=-0.103,OR=0.902,95%CI:0.833~0.977)是影响术后阿片类药物镇痛需求的保护因素(P<0.05)。结论女性、有焦虑、抑郁情绪以及自我效能低的患儿更倾向于选择阿片类药物镇痛。临床上应对该类患儿进行健康教育,降低患儿焦虑抑郁情绪,提高患儿的自我效能,进而降低患儿镇痛需求。
Objebtive To analyze the influencing factors of opioid analgesic demand after strabismus surgery in school-age children.Methods A total of 120 children who underwent strabismus surgery at the Ophthalmic Center,the Second Affiliated Hospital Zhejiang University School of Medicine from July 2022 to February 2023 were retrospectively analyzed.According to the need for postoperative opioid analgesia,the children were divided into the demand group with 43 children and the non-demond group with 77 children.Univariate analysis and logistic multivariate regression analysis were used to analyze the age,gender,residence,parents'education level,family average monthly income,body mass index(BMI),preoperative pain degree,whether to use opioids before surgery,preoperative self-rating anxiety scale(SAS),self-rating depression scale(SDS),and general self-efficacy scale(GSES)of children,postoperative systolic blood pressure,and postoperative diastolic blood pressure on the demand for opioid analgesia after strabismus surgery in school-age children.Results Univariate analysis showed that there were statistically significant differences in gender,SAS,SDS and GSES between the demand group and the non-demand group(P<0.05).Multivariate analysis showed that female(β=0.900,OR=2.460,95%CI:1.137-5.322),high SAS(β=0.350,OR=1.418,95%CI:1.102-1.825),high SDS(β=0.123,OR=1.131,95%CI:1.023-1.250)is the demand of the postoperative opioid analgesic risk factors(P<0.05).High GSES(β=-0.103,OR=0.902,95%CI:0.833-0.977)is the protection factors affecting postoperative opioid analgesic requirements(P<0.05).Conclusion Women,with anxiety,depression and low self-efficacy of children more likely to choose opioid analgesic.In clinical practice,health education should be carried out to reduce the anxiety and depression of children,improve the children's self-efficacy,and thus reduce the analgesic demand of children.
作者
吴云涛
叶伟娣
WU Yuntao;YE Weidi(Department of Anesthesiology,Ophthalmic Center,the Second Affiliated Hospital Zhejiang University School of Medicine,Zhejiang Province,Hangzhou 310000,China)
出处
《中国当代医药》
CAS
2023年第26期134-137,共4页
China Modern Medicine
关键词
学龄期
儿童
斜视手术
阿片类药物
镇痛
School age
Children
Strabismus surgery
Opioids
Analgesia
