以护理为主导实施的镇静镇痛方案对机械通气重症肺炎患者的临床研究

发布时间：2018-03-26 14:06

本文选题：镇静镇痛　切入点：机械通气　出处：《实用医学杂志》2014年16期

【摘要】：目的:分析以护理为主导实施的镇静方案对机械通气的重症肺炎患者的临床疗效。方法:病例来源于2012年1月至2013年1月期间我院重症医学科的重症肺炎机械通气患者共60例。年龄介于18~65岁,性别不限。两组患者治疗前的年龄、性别组成、APACHEII、CPIS、初始呼吸机参数(PSV、O2%、PEEP和f)、MAP、HR等一般情况比较,差异无显著性,具有可比性(P0.05)。结果 :与对照组比较,试验组的镇静药物用量及总镇静时间较对照组明显减少(P0.05);试验组的机械通气时间和ICU时间明显减少(P0.05);试验组的呼吸机相关肺炎发生率明显降低(P0.05)。纳入2周时,试验组的氧合指数明显高于对照组(P0.05);与对照组比较,试验组的CIPS则明显降低(P0.05)。两组患者治疗2周后的疗效比较,其中试验组总有效率为76.7%,对照组为60.0%,组间比较差异显著(P0.05)。两组患者的VAS、谵妄发生率、严重不适发生率及意外拔管率比较,差异均无显著性(P0.05)。结论:以护理为主导实施的镇静方案对机械通气的重症肺炎患者有确切疗效,且不增加患者严重不适、疼痛及意外拔管等不良情况发生。
[Abstract]:Objective: to analyze the clinical curative effect of sedation regimen guided by nursing on patients with severe pneumonia after mechanical ventilation. Methods: patients with severe pneumonia from January 2012 to January 2013 in our hospital were treated with mechanical ventilation of severe pneumonia. There were 60 patients with Qi, aged between 18 and 65, There was no significant difference in age, sex composition, CPISs, PSV O2PEEP and MAPHR between the two groups before treatment. Results: compared with the control group, there was no significant difference between the two groups, and there was no significant difference between the two groups, and there was no significant difference between the two groups. Results: compared with the control group, there was no significant difference between the two groups. The dosage and total sedation time of sedative drugs in the test group were significantly lower than those in the control group, the mechanical ventilation time and the ICU time in the experimental group were significantly decreased than those in the control group, and the incidence of ventilator-associated pneumonia in the experimental group was significantly decreased at 2 weeks. The oxygenation index in the trial group was significantly higher than that in the control group (P 0.05), and the CIPS in the test group was significantly lower than that in the control group. The total effective rate of the test group was 76.7g and that of the control group was 60.05.There was a significant difference between the two groups (P 0.05). The incidence of Vas, delirium, severe discomfort and accidental extubation were compared between the two groups. Conclusion: the sedation regimen with nursing as the leading method has definite curative effect on severe pneumonia patients with mechanical ventilation, and does not increase the adverse conditions such as severe discomfort, pain and accidental extubation.
【作者单位】：广东省中山市人民医院脑血管介入科;
【分类号】：R563.1

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