持续浅镇静目标导向调控方案在机械通气患者中的应用研究

发布时间：2018-04-27 05:02

本文选题：清醒镇静 + 重症监护病房　；参考：《中华护理杂志》2017年04期

【摘要】：目的探讨持续浅镇静目标导向调控方案在机械通气患者中的应用效果。方法选取2013年1月—2015年12月在我院治疗的90例机械通气患者分为试验组和对照组,试验组采用我科自行设计的持续浅镇静目标导向调控方案进行持续浅镇静,对照组应用常规镇静方案,记录并比较两组的镇静药物人均总剂量、机械通气时间、ICU住院时间、ICU病死率、呼吸机相关性肺炎、气胸、患者意外拔管、气管切开发生率。结果试验组机械通气时间、ICU住院时间、镇静药物人均总剂量、呼吸机相关肺炎发生率和气管切开率明显低于对照组,差异具有统计学意义(P0.05)。两组的意外拔管率、再次插管率和气胸发生率比较,差异无统计学意义(P0.05)。结论持续浅镇静目标导向调控方案可以减少镇静镇痛药物的总剂量,缩短ICU住院时间,降低机械通气时间,降低呼吸机相关性肺炎的发生率和气管切开率,安全有效,并可改善机械通气患者预后。
[Abstract]:Objective to investigate the effect of target-oriented control of sustained shallow sedation in patients with mechanical ventilation. Methods from January 2013 to December 2015, 90 patients with mechanical ventilation in our hospital were divided into two groups: the experimental group and the control group. The patients in the control group were treated with routine sedative regimen. The total dose of sedative drugs per capita, the duration of mechanical ventilation and the time of ICU hospitalization were recorded and compared. The mortality rate of ICU, ventilator-associated pneumonia, pneumothorax, accidental extubation and tracheotomy were recorded and compared between the two groups. Results the duration of mechanical ventilation, the total dose of sedatives, the incidence of ventilator-associated pneumonia and the rate of tracheotomy in the experimental group were significantly lower than those in the control group (P 0.05). There was no significant difference in the rate of accidental extubation, re-intubation rate and pneumothorax rate between the two groups (P 0.05). Conclusion the sustained shallow sedation targeting control scheme can reduce the total dose of sedative analgesic drugs, shorten the hospitalization time of ICU, reduce the time of mechanical ventilation, reduce the incidence of ventilator-associated pneumonia and the rate of tracheotomy, and make it safe and effective. It can improve the prognosis of patients with mechanical ventilation.
【作者单位】：镇江市第一人民医院重症医学科;镇江市第一人民医院护理部;
【基金】：卫生部国家临床重点专科建设项目江苏大学医学临床科技发展基金项目(JLY20140007) 镇江市社会发展支撑基金项目(SH2014052)
【分类号】：R614

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