安全护理对ICU机械通气患者镇静治疗及康复效果的影响

Effect of safety nursing on sedation therapy and rehabilitation of ICU patients with mechanical ventilation

目的探讨安全护理对ICU机械通气患者镇静治疗及康复效果的影响,以期为进一步提高镇静治疗的临床效果提供参考。方法选取2016年3月至2018年3月我院ICU病房接收的66例危重患者作为研究对象,采用家属抽签的方式随机将患者分为对照组(30例)与观察组(36例)。两组患者机械通气后均采用咪达唑仑及丙泊酚进行镇静镇痛治疗。对照组给予常规给药护理措施,观察组给予安全护理干预。比较两组患者的Ramsay镇静评分、置管时间、非计划拔管发生情况、呼吸机相关肺炎发生情况及家属护理满意度。结果观察组的Ramsay镇静评分及置管时间均优于对照组,差异具有统计学意义(P<0.05)。观察组非计划拔管及呼吸机相关肺炎发生率均低于对照组,差异具有统计学意义(P<0.05)。观察组家属护理满意度高于对照组,差异具有统计学意义(P<0.05)。结论安全护理应用于ICU机械通气患者镇静治疗中可有效减少患者镇静不良反应的发生,改善镇静效果,提高家属护理满意度,对于保障机械通气安全、营造和谐的护患关系具有积极意义,应大力推广应用。

Objective To explore the effect of safety nursing on sedation therapy and rehabilitation of ICU patients with mechanical ventilation, so as to provide reference for further improving the clinical effect of sedation therapy.Methods A total of 66 critically ill patients in ICU ward of our hospital from March 2016 to March 2018 were selected as the study objects and divided into control group (30 cases) and observation group (36 cases) by drawing lots from their families.After mechanical ventilation, midazolam and propofol were used for sedation and analgesia in both groups.The control group was given routine medication nursing measures, while the observation group was given safety nursing intervention.Ramsey sedation score, indwelling time, incidences of accidental extubation and ventilator-associated pneumonia, and nursing satisfaction of family members were compared between the two groups.Results The Ramsay sedation score and catheterization time of the observation group were better than those of the control group, and the differences were statistically significant (P<0.05).The incidences of unplanned extubation and ventilator-associated pneumonia in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05).The nursing satisfaction of family members in observation group was higher than that in control group, and the difference was statistically significant (P<0.05).Conclusion Safety nursing applied in sedation treatment of ICU patients with mechanical ventilation can effectively reduce the occurrence of adverse reactions of sedation, and improve the sedation effect and the satisfaction of family members.It has positive significance for ensuring the safety of mechanical ventilation and building a harmonious relationship between nurses and patients.It should be vigorously promoted and applied.