电子鼻咽喉镜检查时患儿哭闹原因分析及对电子鼻咽喉镜检查的影响

Analysis of crying in children during electronic nasopharyngoscopy and its influence on electronic nasopharyngoscopy

摘要:

目的 分析电子鼻咽喉镜检查时儿童哭闹的原因及对电子鼻咽喉镜检查的影响。方法 对2020年1月－2020年12月在南京医科大学附属儿童医院喉镜室检查的895例患儿的哭闹原因进行分析，并探讨其对电子鼻咽喉镜检查的影响。结果 男患儿与女患儿哭闹比例比较，差异无统计学意义（P = 0.285）；婴儿组与学龄前期组哭闹比例比较，差异无统计学意义（P = 0.437），其他年龄组间哭闹比例比较，差异有统计学意义（P = 0.000）；父母焦虑组（n = 69）哭闹78.3%（54例），明显较非焦虑组（n = 753）35.3%（266例）高，两组比较，差异有统计学意义（P = 0.000）；儿童相互影响组（n = 73）哭闹84.9%（62例），明显较非相互影响组（n = 753）35.3%（266例）高，两组比较，差异有统计学意义（P = 0.000）。哭闹的影响因素分析，学龄期以前组哭闹造成的检查受阻、鼻出血和引发父母焦虑比例明显高于未哭闹儿童组，差异有统计学意义（均P = 0.000）；学龄期哭闹造成检查受阻和鼻出血比例与未哭闹儿童比较，差异有统计学意义（P = 0.009和P = 0.000）。检查所需时间方面，哭闹组鼻镜、喉镜检查时间均长于未哭闹组，差异有统计学意义（均P = 0.000）。结论 父母焦虑、儿童间相互影响对儿童电子鼻咽喉镜检查前哭闹具有明显的负影响，儿童哭闹会增加鼻出血风险，降低检查流畅性，延长检查时间，且会引发父母焦虑。这些因素为进一步优化儿童电子鼻咽喉镜检查的舒适度和效率提供了方向。

Abstract:

Objective To analyze the factors affecting children crying during electronic nasopharyngoscopy and its influence on electronic nasopharyngoscopy.Methods The factors of crying in 895 children examined in the laryngoscopy room from January to December in 2020 were analyzed, and the influence of crying factors on electronic nasopharyngoscopy was discussed.Results The results indicated that there was no significant difference in crying between the male and female (P = 0.285). There was no significant difference in crying between infant group and pre-school age group (P = 0.437), but there was significant difference in crying between other age groups (P = 0.000). The children crying in parents’ anxiety group (n = 69) was significant more than that in non-anxiety group (n = 753) [78.3% (54) vs 35.3% (266)], and there was significant difference between the two groups (P = 0.000). The children crying in child interaction group (n = 73) was significant more than that in non-interaction group (n = 753) [84.9% (62) vs 35.3% (266)], and there was significant difference between the two groups (P = 0.000). When discussing the influence of crying, it was found that the cases of blocked examination, nosebleed and parental anxiety caused by crying in the pre-school-age group were significantly more than those in the non-crying group, with statistically significant differences (all P = 0.000). There were statistically significant differences in the number of school-age children with blocked examination and nosebleed caused by crying compared with those without crying (P = 0.009 and P = 0.000). In terms of examination time, both nasal and laryngoscopic crying group were longer than non-crying group, with statistically significant differences (all P = 0.000).Conclusion Parent anxiety and the interaction between children have a significant negative impact on the crying proportion before electronic nasopharyngoscope examination in children, and children's crying will increase the risk of epistaxis, reduce the examination fluency, prolong the examination time, and also cause parents' anxiety. The findings of these factors and influences provide a direction for the further optimization of comfort and efficiency of electronic nasopharyngoscopy in children.