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缓解术前焦虑对儿童腹股沟斜疝疝囊高位结扎腹腔镜术后胃肠功能恢复的影响。

Effect of Alleviating Preoperative Anxiety on Gastrointestinal Function Recovery After Laparoscopic High Ligation of the Hernia Sac in Children with Indirect Inguinal Hernia.

机构信息

Department of Anesthesiology, Jinzhou Medical University, Jinzhou, Liaoning, People's Republic of China.

Department of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.

出版信息

Drug Des Devel Ther. 2024 Aug 5;18:3477-3486. doi: 10.2147/DDDT.S461097. eCollection 2024.

Abstract

PURPOSE

Anxiety and depression can affect the physiology of the gastrointestinal tract through the brain-gut axis, causing gastrointestinal dysfunction, which is mainly manifested as indigestion, diarrhoea, constipation, or abdominal pain. Preoperative anxiety arises in children due to separation from parents, fear of unfamiliar surroundings and anaesthesia and surgical procedures.To discuss the effect of alleviating preoperative anxiety on postoperative recovery of gastrointestinal function in children with indirect inguinal hernia after laparoscopic high ligation of the hernia sac.

PATIENTS AND METHODS

90 children with laparoscopic high ligation of the herniated sac in oblique inguinal hernia were randomly divided into control group (Group C) and experimental group (Group M). The Group M was given midazolam oral solution 0.5mg/kg (maximum dose 20mg), and The Group C was given 5% glucose solution with the same dose.Primary outcome was the time to first postoperative defecation and I-FEED scores.The secondary outcomes included mYPAS-SF scores; child sedation scores; child-parent separation scores; parental STAI scores;PHBQ scores;FLACC scores, operative time, and fluid input and surgeon job satisfaction.

RESULTS

Compared with Group C, there was a shorter time to first postoperative defecation (P < 0.05), and lower I-FEED scores on postoperative day 1 (P < 0.05). The mYPAS-SF scores, which were significantly different in Group M at T1, T2, and T3 (P < 0.05), parental STAI scores at S1, child sedation scores and child-parent separation scores in T1, and surgeon job satisfaction between the two groups were significantly different (P < 0.05). There were no statistically significant differences in I-FEED scores on days 2 and 3, PHBQ scores, FLACC scores, operative time, and fluid input between the two groups of children (P > 0.05).

CONCLUSION

Preoperative application of midazolam oral solution to relieve preoperative anxiety helps to promote the recovery of postoperative gastrointestinal function in children with indirect inguinal hernia and increases the surgeon job satisfaction.

摘要

目的

焦虑和抑郁可通过脑-肠轴影响胃肠道生理功能,导致胃肠功能障碍,主要表现为消化不良、腹泻、便秘或腹痛。由于与父母分离、对陌生环境和麻醉及手术过程的恐惧,儿童在术前会产生焦虑。本研究旨在探讨术前应用咪达唑仑口服液缓解焦虑对腹腔镜疝囊高位结扎术治疗小儿腹股沟斜疝术后胃肠功能恢复的影响。

方法

将 90 例行腹腔镜疝囊高位结扎术的小儿腹股沟斜疝患儿随机分为对照组(C 组)和实验组(M 组)。M 组患儿给予咪达唑仑口服液 0.5mg/kg(最大剂量 20mg),C 组给予等剂量 5%葡萄糖溶液。主要结局指标为首次术后排便时间和 I-FEED 评分。次要结局指标包括 mYPAS-SF 评分、患儿镇静评分、患儿-家长分离评分、家长状态-特质焦虑量表(STAI)评分、父母心理困扰问卷(PHBQ)评分、面部表情疼痛评分量表(FLACC)评分、手术时间、液体输入量和术者满意度。

结果

与 C 组相比,M 组患儿首次术后排便时间更短(P < 0.05),术后第 1 天 I-FEED 评分更低(P < 0.05)。M 组患儿 T1、T2 和 T3 时 mYPAS-SF 评分差异有统计学意义(P < 0.05),S1 时家长 STAI 评分、T1 时患儿镇静评分和患儿-家长分离评分以及两组术者满意度差异均有统计学意义(P < 0.05)。两组患儿术后第 2、3 天 I-FEED 评分、PHBQ 评分、FLACC 评分、手术时间和液体输入量比较差异均无统计学意义(P > 0.05)。

结论

术前应用咪达唑仑口服液缓解焦虑有助于促进小儿腹股沟斜疝术后胃肠功能恢复,提高术者满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/350f/11313495/21d0ec0718f1/DDDT-18-3477-g0001.jpg

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