解放军护理杂志
解放軍護理雜誌
해방군호리잡지
NURSING JOURNAL OF CHINESE PEOPLE'S LIBERATION ARMY
2014年
20期
13-16
,共4页
郑盼盼%章敏%田小玲%金王燕%陈师之
鄭盼盼%章敏%田小玲%金王燕%陳師之
정반반%장민%전소령%금왕연%진사지
每日唤醒%机械通气%镇静%谵妄
每日喚醒%機械通氣%鎮靜%譫妄
매일환성%궤계통기%진정%섬망
daily awaking%mechanical ventilation%sedation%delirium
目的：探索每日唤醒干预对接受机械通气镇静治疗危重患者的有效性和可行性。方法便利抽样选择2011年8月至2012年12月收治杭州市萧山区第一人民医院重症监护病房（ICU）的177例患者，按照入院时间分为试验组（88例）和对照组（89例），对照组采取镇静药物持续输注，试验组在此基础上实施每日唤醒，比较两组患者镇静药物使用量、机械通气时间、ICU治疗时间、谵妄发生率、护理相关不良事件（如意外拔管、人机对抗、坠床等）及原疾病相关并发症发生率。结果试验组镇静药物用量、机械通气时间、ICU治疗天数明显低于对照组，差异均有统计学意义（均P＜0．05），两组丙泊酚用量、谵妄发生率、不良事件及相关并发症发生率比较，差异均无统计学意义（均P＞0．05）。结论每日唤醒是预防机械通气危重患者过度镇静的一项安全有效的措施，对患者预后具有积极意义。
目的：探索每日喚醒榦預對接受機械通氣鎮靜治療危重患者的有效性和可行性。方法便利抽樣選擇2011年8月至2012年12月收治杭州市蕭山區第一人民醫院重癥鑑護病房（ICU）的177例患者，按照入院時間分為試驗組（88例）和對照組（89例），對照組採取鎮靜藥物持續輸註，試驗組在此基礎上實施每日喚醒，比較兩組患者鎮靜藥物使用量、機械通氣時間、ICU治療時間、譫妄髮生率、護理相關不良事件（如意外拔管、人機對抗、墜床等）及原疾病相關併髮癥髮生率。結果試驗組鎮靜藥物用量、機械通氣時間、ICU治療天數明顯低于對照組，差異均有統計學意義（均P＜0．05），兩組丙泊酚用量、譫妄髮生率、不良事件及相關併髮癥髮生率比較，差異均無統計學意義（均P＞0．05）。結論每日喚醒是預防機械通氣危重患者過度鎮靜的一項安全有效的措施，對患者預後具有積極意義。
목적：탐색매일환성간예대접수궤계통기진정치료위중환자적유효성화가행성。방법편리추양선택2011년8월지2012년12월수치항주시소산구제일인민의원중증감호병방（ICU）적177례환자，안조입원시간분위시험조（88례）화대조조（89례），대조조채취진정약물지속수주，시험조재차기출상실시매일환성，비교량조환자진정약물사용량、궤계통기시간、ICU치료시간、섬망발생솔、호리상관불량사건（여의외발관、인궤대항、추상등）급원질병상관병발증발생솔。결과시험조진정약물용량、궤계통기시간、ICU치료천수명현저우대조조，차이균유통계학의의（균P＜0．05），량조병박분용량、섬망발생솔、불량사건급상관병발증발생솔비교，차이균무통계학의의（균P＞0．05）。결론매일환성시예방궤계통기위중환자과도진정적일항안전유효적조시，대환자예후구유적겁의의。
Objective To explore the effect and feasibility of daily awaking strategy for severe mechanically ventilated patients with sedation.Methods By convenience sampling,177 patients were selected and admitted to ICU from August 2011 to December 2012 and according to the time coming to hosptial were randomized into experimental group(n=88)and control group(n=89).Patients in the control group received continuous sedative infusion,while patients in the experimental group were intervened with daily awaking(DA).The doses of sedatives,durations of mechanical ventilation,ICU stay,incidence of delirium, nursing relevant adverse accidents such as accident extubation,man-machine counteraction,falling out of bed and other complications were compared between the two groups.Results The doses of sedatives,dura-tions of mechanical ventilation and days of ICU stay for the patients in the experimental group were signifi-cantly lower than those in the control group (all P<0.05).However,there were no differences for the total dose of propofol,nursing accidents,incidence of delirium and relevant complications between the two groups (all P>0.05 ).Conclusion Daily awaking is a safe intervention to reduce over-sedation among severe mechanically ventilated patients,thus plays a positive role to the outcome of these patients.
