RASS评分指导镇静镇痛对ICU中心静脉导管意外拔管的影响

Effects of sedation and analgesia on ICU central venous catheter extubation by RASS score

目的探讨应用RASS评分指导镇痛镇静对预防中心静脉导管相关并发症非计划拔管的作用。方法纳入2015年1月至2015年12月期间来四川省人民医院ICU病房住院患者共296例,随机分为实验组及对照组,其中对照组采用ICU常规护理,实验组在常规护理基础之上根据RASS评分建立并使用镇痛镇静药技术路线,观察比较两组患者非计划拔管发生率及进行相应风险分析。结果实验组非计划拔管率0.63/100导管日,显著低于对照组4.3/100导管日,且并不显著增加呼吸、循环、神经系统等相关并发症。结论应用RASS评分能够显著降低ICU中心静脉置管患者非计划拔管的发生率,是一种值得应用的护理手段。

Objective To investigate the effect of RASS score-based pain and sedation management on the prevention of central venous catheter-related complications-unplanned extubation. Method 296 patients admitted to our medical center from January 2015 to December 2015 were randomly divided into experiment group and control group. Conventional method of nursing care was adopted in the control group while RASS score-guided nursing care was utilized in the experiment group. The incidence rate of unplanned extubation and relevant hazards between the two groups were assessed and compared. Result The morbidity of unplanned extubation in the experiment group is 0.63 per 100 catheter days significantly lower than the control group 4.3 per 100 catheter days without increasing overdose complication. ConclusionThe RASS score-based pain and sedation management can effectively prevent the central venous catheter related complications-unplanned extubation and deserves to be generalized.