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目的:探讨多方式干预对接受发育性髋关节脱位（developmental dislocation of hip, DDH）矫形手术患儿围手术期精神状态和疼痛的影响。方法:选择择期行DDH矫形手术的患儿120例，ASA分级Ⅰ、Ⅱ级，年龄2~5岁，体重12~21 kg。采用随机数字表法将患儿分为4组：宣教+神经阻滞组（PN组）、宣教+术后镇痛组（PA组）、神经阻滞+术后镇痛组（NA组）、宣教+神经阻滞+术后镇痛组（PNA组），每组30例。4组患儿均常规诱导气管插管行全身麻醉，七氟醚、瑞芬太尼用于术中麻醉维持。PN组、PA组、PNA组患儿术前访视时给予动画视频宣教手术和麻醉过程，PN组、NA组、PNA组患儿全身麻醉诱导后给予超声引导下股外侧皮神经阻滞，PA组、NA组、PNA组患儿术后给予父母控制静脉镇痛。记录术前访视时（Tn 0）、入手术室时（Tn 1）、麻醉诱导时（Tn 2）、术后12 h（Tn 3）、术后24 h（Tn 4）、术后48 h（Tn 5）患儿的心率、MAP、改良耶鲁围手术期焦虑量表（modified Yale Preoperative Anxiety Scale, mYPAS）评分。根据诱导期合作度量表（Induction Compliance Checklist, ICC）评估麻醉诱导时患儿的合作程度并记录ICC评分。同时测定并记录术后0.5 h（T\'n 0）、术后2 h（T\'n 1）、术后12 h（T\'n 2）、术后24 h（T\'n 3）、术后48 h（T\'n 4）患儿VAS疼痛评分及术中芬太尼用药量。观察并记录围手术期寒战、恶心呕吐、呼吸抑制、出血等并发症发生情况。n 结果:4组患儿年龄、性别比、体重、手术时间、输液量及出血量等比较差异无统计学意义（n P>0.05）。与NA组比较，PN组、PA组、PNA组患儿在Tn 1、Tn 2、Tn 3、Tn 4时的心率、MAP、mYPAS评分明显降低（n P<0.05），而在Tn 5时心率、MAP也明显降低（n P<0.05）。与PNA组比较，PN组和PA组心率、MAP、mYPAS评分在Tn 3、Tn 4时明显升高，差异有统计学意义（n P<0.05）。与NA组比较，PN组、PA组、PNA组患儿麻醉诱导时ICC评分明显降低（n P<0.05）。与PA组比较，PN组、NA组、PNA组患儿在T\'n 0、T\'n 1、T\'n 2、T\'n 3、T\'n 4时的VAS疼痛评分明显降低，（n P<0.05）；与PN组比较，NA组、PNA组患儿T\'n 0、T\'n 1、T\'n 2、T\'n 3、T\'n 4时点VAS疼痛评分也明显降低（n P<0.05）。与PA组比较，PN组、NA组、PNA组患儿术中芬太尼用量明显减少（n P0.05). Compared with the NA group, the heart rate, MAP and mYPAS scores of the PN, PA and PNA groups were significantly low (n P<0.05) at Tn 1, Tn 2, Tn 3 and Tn 4. Heart rate and MAP at Tn 5 were also appreciably low (n P<0.05). Compared with PNA group, the heart rate, MAP and mYPAS scores of PNA and PA groups at Tn 3 and Tn 4 were significantly high (n P<0.05). During anesthesia induction, compared with the NA group, the ICC scores of PN, PA, and PNA groups had low scores (n P<0.05). Compared with the PA group, the VAS scores of PN, NA, and PNA groups at T\'n 0, T\'n 1, T\'n 2, T\'n 3, and T\'n 4 were significantly low (n P<0.05). While compared with PN groups, the VAS scores of NA and PNA were significantly low at these five time points (n P<0.05). During the intraoperative period, compared with the PA group, the fentanyl dosage of PN, NA, PNA groups was low (n P<0.05). No obvious complications occurred in all groups.n Conclusions:Preoperative education and multimodal analgesia intervention can relieve anxiety and tension in children undergoing DDH orthopedic surgery. It can also reduce the VAS scores and fentanyl usage during the perioperative period.