早期目标导向型镇静改善老年肺炎机械通气患者肠内营养耐受性的效果

发布时间：2018-05-23 21:10

本文选题：早期目标导向型镇静 + 机械通气肺炎　；参考：《中国老年学杂志》2017年08期

【摘要】：目的探究早期目标导向型镇静(EGDS)在改善机械通气老年肺炎患者肠内营养耐受性的临床效果。方法 68例重症监护室(ICU)接受机械通气治疗的肺炎患者按入院先后分为EGDS组(38例)和对照组(30例)。对照组实行标准化镇静策略,EGDS组实行EGDS策略进行镇静。停药后就两组呼吸及循环参数进行比较,同时对比两组肠内营养开始时间、营养目标达标时间及其机械通气时间,并就各项并发症发生情况进行比较。结果用药期间,两组平均动脉压(MBP)、呼吸频率(RR)、动脉氧分压(PaO_2)无显著差异(P0.05),两组心率(HR)存在显著差异(P0.05)。EGDS组机械通气时间、肠内营养开始时间和营养目标达标时间均显著低于对照组(P0.05)。肠内营养并发症方面,EGDS组胃潴留、呕吐、反流误吸发生率均显著低于对照组(P0.05)。结论 EGDS的应用避免了对机械通气肺炎患者的过度镇静,对肠胃功能起到一定的保护作用,使其肠内营养耐受性得到显著提升。
[Abstract]:Objective to investigate the clinical effect of early goal-oriented sedation (EGDS) in improving enteral nutrition tolerance in elderly patients with mechanical ventilation pneumonia. Methods 68 patients with pneumonia treated by mechanical ventilation in intensive care unit were divided into EGDS group (n = 38) and control group (n = 30). The control group was treated with standardized sedative strategy and the EGDS group was treated with EGDS strategy. The respiratory and circulatory parameters of the two groups were compared after withdrawal, and the beginning time of enteral nutrition, the time of meeting the nutritional target and the time of mechanical ventilation were compared, and the occurrence of various complications was compared. Results there was no significant difference in mean arterial pressure (MBP), respiratory frequency (RRN) and arterial partial pressure of oxygen (PaO2) between the two groups during the treatment period (P 0.05), but there was a significant difference in HR between the two groups (P 0.05) and the time of mechanical ventilation in EGDS group. The beginning time of enteral nutrition and the time of reaching the standard of nutrition target were significantly lower than that of the control group (P 0.05). The incidence of gastric retention, vomiting and reflux aspiration in EGDS group was significantly lower than that in control group (P 0.05). Conclusion the application of EGDS can avoid excessive sedation in patients with mechanical ventilation pneumonia, protect gastrointestinal function and improve enteral nutrition tolerance.
【作者单位】：绍兴市人民医院重症医学科;
【基金】：浙江省医药卫生科技计划(No.2016KYB308)
【分类号】：R563.1

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