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摘要: 小儿日间手术可最大限度地减少患儿与父母的分离,缓解患儿的焦虑情绪,降低医疗成本。然而,由于小儿特殊的解剖和生理学特点,麻醉术后易发生疼痛、恶心呕吐和谵妄等并发症。因此,术后管理是小儿日间手术顺利实施的重要环节之一,其规范化管理对于保障患儿安全,提高日间手术医疗质量起着至关重要的作用。本文就小儿日间手术术后常见并发症及出院标准相关研究进展进行综述。Abstract: Pediatric ambulatory surgery can minimize the separation of pediatric patients from their parents, relieve anxiety, and offer care at a reduced cost. However, children are prone to experiencing pain, nausea, vomiting, delirium, and other complications after anesthesia and ambulatory surgery due to their anatomical and physiological characteristics. So, standardized postoperative management is critical to ensure the safety of children and improve the medical quality of pediatric ambulatory surgery. This article reviews new progress in research on common postoperative complications and discharge criteria of pediatric ambulatory surgery.作者贡献:刘超群负责文献检索及初稿撰写;朱波、申乐和黄宇光负责论文审核及修订。利益冲突:无
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表 1 基于生理学标准的出院评分系统[27]
项目 具体描述 评分 意识水平 清醒定向,动作适当 2 在最小的刺激下能被唤醒,动作微弱 1 只对触觉刺激有反应,无动作 0 呼吸状态 能够咳嗽、深呼吸或哭泣 2 哭泣或咳嗽时声嘶 1 喘鸣、呼吸困难或气喘 0 氧合情况 呼吸室内空气脉搏氧饱和度大于95% 2 呼吸室内空气脉搏氧饱和度维持在90%~95% 1 吸氧时脉搏氧饱和度才大于90% 0 血流动力学稳定性 心率、血压在基础值15%以内 2 心率、血压超出基础值15%~30% 1 心率、血压超出基础值30%以上 0 术后疼痛 无或轻度不适 2 需静脉镇痛的中、重度疼痛 1 持续剧烈疼痛 0 术后恶心呕吐 无或轻度恶心、无呕吐 2 短暂呕吐或干呕 1 持续性中、重度恶心呕吐 0 切口部位 无血液或体液丢失 2 血液或体液丢失较小,无需干预 1 血液或体液持续丢失,需补充 0 -
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