镇静方案不同控制目标在机械通气患者长途院间转诊中的运用研究

发布时间：2018-01-03 22:28

本文关键词：镇静方案不同控制目标在机械通气患者长途院间转诊中的运用研究　出处：《中国全科医学》2017年14期 　论文类型：期刊论文

【摘要】：目的探讨镇静方案不同控制目标在机械通气患者长途院间转诊中的运用效果。方法选取2015年5月—2016年5月需长途转诊至重庆医科大学附属第一医院的患者117例,按照转诊日期进行分组,奇数日转诊者为对照组(60例),偶数日转诊者为观察组(57例)。患者均接受有创机械通气,转诊过程中使用芬太尼和丙泊酚联合镇静方案,对照组控制目标为Riker镇静、躁动评分(SAS)4分,观察组控制目标为SAS 2分,比较两组不同时间心率、呼吸、平均动脉压(MAP)、血氧饱和度(SpO_2)和不良事件(气管移位、导管滑脱、坠床、呕吐、压力性损伤)的发生情况。结果用药前及开始转诊后0、30、150 min两组心率比较,差异均无统计学意义(P0.05);开始转诊后60、90、120 min观察组心率较对照组减慢(P0.05)。用药前两组呼吸比较,差异无统计学意义(P0.05);开始转诊后0、30、60、90、120、150 min观察组呼吸较对照组减慢(P0.05)。用药前及开始转诊后0、30、120、150min两组MAP比较,差异均无统计学意义(P0.05);开始转诊后60 min观察组MAP较对照组升高,开始转诊后90min观察组MAP较对照组降低(P0.05)。用药前及开始转诊后0、30、60、90、120、150 min两组SpO_2比较,差异均无统计学意义(P0.05)。观察组气管移位、导管滑脱、坠床及总不良事件发生率较对照组降低(P0.05);两组呕吐和压力性损伤发生率比较,差异均无统计学意义(P0.05)。结论使用有创机械通气的患者转诊时控制目标为SAS 2分的镇静方案既保证血流动力学的稳定,又有效地控制了不良事件的发生。
[Abstract]:Objective to investigate the sedative effect by using different control scheme target diagnosis in patients with mechanical ventilation in inter - hospital. Methods 117 patients from May 2015 to May 2016 for referral to First Affiliated Hospital of Chongqing Medical University, were grouped according to the date of referral, odd numbered days of referral for the control group (60 cases), even days of referral for observation group (57 cases). The patients received mechanical ventilation, fentanyl and propofol sedation scheme using the referral process, control group control objectives for the Riker sedation agitation scale (SAS) score of 4, the observation group control goal for the SAS 2, compared with two groups of different time breathing, heart rate, mean arterial pressure (MAP), oxygen saturation (SpO_2) and adverse events (trachea, catheter slippage, falling out of bed, vomiting, pressure injury). The incidence of the medication before and after referral 0,30150 min heart rate of the two groups, there was no difference Statistical significance (P0.05); 60,90120 min began to turn after the observation group compared with the control group decreased heart rate (P0.05). The two group was breathing before treatment, the difference was not statistically significant (P0.05); 0,30,60,90120150 min began to turn after the observation group compared with the control group, slow breathing (P0.05). Before treatment and referral started 0,30120150min two group MAP, there were no significant differences (P0.05); after 60 min turned MAP in the observation group was higher than the control group, the observation group began referral 90min MAP lower than the control group (P0.05). Before treatment and after 0,30,60,90120150 began to min two group SpO_2, there were no significant differences (P0.05). The observation group tracheal shift catheter slippage, falling out of bed, and the total incidence of adverse events was lower than the control group (P0.05); the two groups occurred vomiting and pressure injury rate comparison, there were no significant differences (P0.05). Conclusion the use of invasive mechanical ventilation patients The sedative scheme, which controls the target of SAS 2, not only ensures the stability of the hemodynamics, but also effectively controls the occurrence of adverse events.

【作者单位】：重庆医科大学附属第一医院急诊科;
【基金】：重庆市卫计委课题资助项目(2015MSXM003) 重医一院护理科研基金(HLJJ2016-19)
【分类号】：R459.7
【正文快照】： 2015年国务院发布《关于推进分级诊疗制度建设的指导l%k k k k k k k k k k k k k k k k k k k k k l%k 同行评议:k 意见》[1]明确提出双向转诊制度,逐步实现不同级别、不同类k 危重患者院间转诊尤其是需要有创机械通气的患者k 别医院之间的有序转诊,长途院间转诊的患者数量日

【相似文献】