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目的探讨不同麻醉方式对咽部手术患儿近期医疗恐惧程度及对其远期身心健康的影响,为选择合理的麻醉方式提供依据。方法选择行咽部手术采用局麻和全麻的患儿各48例,应用儿童医疗恐惧量表(CMFS)调查手术前后恐惧程度;选择行全麻和局麻咽部手术术后3~5年的儿童各50例,参照蒙特梭利儿童观中儿童恐惧症状及身心健康的表现,自行设计心理状况问卷调查表进行相关的身心健康调查。结果住院局麻组患儿术后恐惧评分(除注射、呕吐2项外)显著高于全麻组患儿(P<0.05,P<0.01);出院局麻组患儿的恐惧症状及对生活学习的影响显著高于全麻组患儿(P<0.05,P<0.01)。结论局麻方式对咽部手术患儿造成的恐惧较高,对患儿生活学习甚至择业均造成一定程度的影响。医务人员应告知家长两种麻醉方式的优缺点,根据具体情况合理选择麻醉方式,以最大限度降低患儿的恐惧感,提高其手术后的生活质量。
Objective To explore the effects of different anesthesia on the recent medical fear and its long-term physical and mental health in children with pharyngeal surgery, and to provide a basis for choosing a reasonable anesthetic mode. Methods Forty-eight children with local anesthesia and general anesthesia were selected for pharyngeal surgery. The children’s medical fear scale (CMFS) was used to investigate the degree of fear before and after surgery. Three to five years after general anesthesia and local anesthesia and throat surgery Of children, each with 50 cases. Based on Montessori’s view of children’s fear and physical and mental health, self-designed questionnaire of psychological status was conducted to conduct relevant physical and psychological health survey. Results The scores of postoperative phobia (except 2 cases of injection and vomiting) in hospitalized anesthesia group were significantly higher than those of general anesthesia group (P <0.05, P <0.01) The effect of learning was significantly higher in children with general anesthesia (P <0.05, P <0.01). Conclusion The method of local anesthesia in children with pharyngeal surgery caused by higher fear of children’s lives and learning or career have a certain degree of impact. Medical staff should inform parents of the advantages and disadvantages of the two anesthesia methods, according to the specific circumstances of a reasonable choice of anesthesia in order to minimize the fear of children and improve their quality of life after surgery.