镇痛镇静规程在有创机械通气患者中的临床应用研究

Clinical Application of Analgesia and Sedation Procedures in Patients with Invasive Mechanical Ventilation

目的探讨镇痛镇静规程在有创机械通气患者中的临床应用效果。方法选取2018年6月至2019年6月于我院ICU收治的92例有创机械通气患者,按照随机数字法分为研究组和对照组,每组各46例。对照组给予常规镇痛镇静护理方案,研究组在对照组基础上给予舒适化镇痛镇静规程护理方案。比较两组患者镇痛镇静药物使用情况、非计划拔管发生率、约束使用率、谵妄发生情况、机械通气时间、ICU住院时间、总住院时间、28天生存率及患者对护理满意度。结果研究组盐酸吗啡注射液及咪达唑仑注射液的使用总剂量及平均剂量均显著低于对照组,非计划拔管率及约束使用率、谵妄发生率较对照组均显著降低,谵妄持续时间、机械通气时间、ICU住院时间、总住院时间较对照组均显著缩短,护理满意度较对照组显著升高,差异有统计学意义(P<0.05)。两组患者28天生存率比较差异无统计学意义(P>0.05)。结论舒适化镇痛镇静规程护理方案较常规护理方案效果更佳,具有临床应用价值。

Objective To investigate the clinical application of analgesia and sedation procedures in patients with invasive mechanical ventilation.Methods From June 2018 to June 2019,92 patients with invasive mechanical ventilation who were admitted to ICU in our hospital were selected and divided into a study group( SG,n = 46) and a control group( CG,n = 46) according to the random number method.CG was given a routine analgesic and sedative nursing program,while RG was given a comfortable nursing program based on CG.The use of analgesic and sedative drugs,the incidence of unplanned extubation,the rate of constrained use,the incidence of delirium,the mechanical ventilation time,ICU hospital stay,total hospital stays,28-day survival rate and patient’s satisfaction with nursing were compared.Results The total and average doses of morphine hydrochloride injection and midazolam injection in SG were significantly lower than those in CG.The rate of unplanned extubation and restraint use,and the incidence of delirium were significantly lower than those in CG.The delirium continued time,mechanical ventilation time,ICU hospitalization time,and total hospitalization time were significantly shorter than CG,and the nursing satisfaction was significantly higher than CG,those differences were statistically significant( P<0. 05).There was no significant difference in 28-day survival rate between two groups( P>0. 05).Conclusion Comfortable analgesia and sedation procedures nursing program is more effective than conventional nursing plan which has clinical application value.