全程镇静模拟人体生物钟模式在ICU机械通气患者中的应用

Effect of whole-body sedation simulation of human biological clock model on patients with mechanical ventilation in ICU

目的探讨全程镇静模拟人体生物钟模式在ICU机械通气患者中的应用，对患者疗效的影响。方法选取2014年8月至2015年11月本院ICU住院机械通气患者80例为研究对象，采用信封分组法将患者随机分为模拟组和非模拟组，两组患者均采用右美托咪定镇静，模拟组模拟人体生物钟模式，非模拟组患者不模拟人体生物钟模式，比较两组患者机械通气时间、拔管时间、ICU住院天数、右美托咪定（DEX）使用剂量及治疗过程中不良反应发生率。结果模拟组患者机械通气时间、拔管时间、ICU住院天数、DEX使用剂量均低于非模拟组，两组比较差异均有统计学意义（均P〈0．05）。模拟组患者谵妄、严重心动过缓、严重低血压及呼吸机相关性肺炎（VAP）发生率均低于非模拟组，两组比较差异均有统计学意义（均P〈0．05）。结论全镇镇静模拟人体生物钟模式在ICU机械通气患者中应用，通过模拟人体正常生物钟降低患者应激反应，能提高患者疗效，降低不良反应发生率。

Objective To explore the effect of whole-body sedation simulation of human biological clock on the patients with mechanical ventilation in ICU. Methods 80 inpatients with mechanical ventilation in ICU from August 2014 to November 2015 were selected and randomly divided into two groups： the simulation group and the non-simulation group. The patients in the two groups were treated with dexmedetomidine, the simulation group simulated the human biological clock model, and the non-simulation group did not simulate the human biological clock model. Compared mechanical ventilation time, extubation time, ICU days of hospitalization, the dose of dexmedetomidine （DEX）, and the incidence of adverse reactions in the course of treatment of the two groups. Results The duration of mechanical ventilation, the time of extubation, the days of ICU stay, and the dose of dexmedetomidine in the simulation group were significantly lower than those in the non-simulation group （P〈0.05）. The incidences of delirium, severe bradycardia, severe hypotension, and ventilator-associated pneumonia in the simulation group were significantly lower than those in the non-simulation group （P〈0.05）. Conclusion The application of whole-body sedation simulation of human biological clock model in patients with mechanical ventilation in ICU can reduce the stress response of patients, improve the efficacy of patients, and reduce the incidence of adverse reactions by simulating the body＇s normal biological clock.