Ramsay评分对降低非计划性拔管发生率及镇静药物使用的影响

Effect of Ramsay scale on reducing the incidence of unplanned extubation and the use of sedative drugs

目的 探讨Ramsay评分对降低非计划性拔管（UEX）发生率及镇静药物使用的影响.方法 将2008年11月16日至2010年11月16日西安交通大学第一附属医院收住重症监护病房的520例气管插管机械通气患者完全随机分为观察组和对照组,各260例.对照组按照预防UEX的护理常规进行护理,并根据患者情况由医师给以丙泊酚并调整剂量;观察组在对照组基础上加用Ramsay镇静评分,由医护人员调整丙泊酚剂量.比较2组患者UEX发生率及镇静药物不良反应发生率.结果 观察组UEX发生率和丙泊酚药物不良反应发生率均明显低于对照组,差异均有统计学意义[1.2％（3/260）比3.1％（8/260）,2.3％ （6/260）比7.7％ （20/260）,均P＜0.05].结论 在气管插管机械通气患者中引入Ramsay镇静评分可以指导护理人员调整镇静药物剂量,并有效降低UEX的发生率,同时降低镇静药物不良反应的发生率.

Objective To investigate the effect of Ramsay scale on reducing incidence of unexpected extubation （UEX） and use of sedative drugs.Methods Totally 520 patients with mechanical ventilation in intensive care unit from November 2008 to November 2010 were randomly divided into observation group and control group （260 cases in each group）.In both groups,the patients received routine nursing for preventing UEX;the dose of propofol was adjusted by the doctors in control group and was adjusted by the nurses according to Ramsay scale score in observation group.The incidences of UEX and adverse reaction of propofol were compared between groups.Results The incidences of UEX and adverse reaction of propofol in observation group were statistically lower than those in control group [1.2% （3/260） vs 3.1% （8/260）,2.3% （6/260） vs 7.7% （20/260）] （P 〈 0.05）.Conclusion Ramsay scale can guide the nurse to adjust the dose of propofol,thus decrease the incidences of UEX and adverse reaction of propofol.