RASS及SAS对ICU重症肺炎机械通气患者镇静的疗效分析

The curative effect analysis of RASS and SAS on sedation of mechanically ventilated ICU patients with severe pneumonia

目的对比Richmond躁动-镇静评分(RASS)与SAS镇静评分(Sedation-Agitation Scale,SAS)的运用效果,探讨两种评分在ICU重症肺炎机械通气患者中的疗效。方法选取2018年11月至2019年9月入住华北理工大学附属医院重症医学科明确诊断为重症肺炎同时需要气管插管机械通气的患者90例,随机分为RASS组与SAS组,应用eCASH(early Comfort using Analgesia,minimal Sedatives and maximal Humane care)理念对所选患者进行常规镇痛镇静,依据RASS与SAS理想镇静评分指导患者镇静治疗。比较与分析两组患者镇静药物剂量、带管时间、自主呼吸恢复时间、ICU的停留时间及不良反应发生率。结果 RASS组患者的带管时间及ICU停留时间均明显短于SAS组,RASS组患者的镇静药使用剂量明显少于SAS组(P<0.05)。干预过程中RASS组患者不良事件的发生率明显低于SAS组患者(P<0.05)。结论 ICU重症肺炎机械通气患者镇静评分应用中,RASS镇静评分的效果较好,值得在今后临床工作中进一步深入研究及推广使用。

Objective To compare the Richmond Agitation-sedation scores(Richmond Agita-tion Sedation Scale,RASS)and SAS sedation scores(sedation-agitation scale,SAS)apply effect,and to discusses the two score the curative effect of patients with severe pneumonia in ICU mechanical ventilation.Methods 90 cases patients who were admitted to the department of critical care from November 2018 to September 2019 Affilated Hospital of North China University of Science and Technology and diagnosed as severe pneunonia and required trachdal intubation mechanical ventilation were selected.They were randomly divided into RASS and SAS group.The selected patients were routinely treated with eCASH concept for analgesia and sedation.RASS and SAS ideal sedation score were used to guide patinets in sedation treatment.And then the dose of sedatives,duration of administration,duration of spontaneous respiratory recovery,duration of ICU stay and incidence of adverse events were compared and analyzed between the two groups.Results The duration of tube stay and ICU stay in the RASS group were significantly shorter than the SAS group,and the dose of sedatives in the RASS group was significantly lower than the SAS group(P<0.05).The incidence of adverse events in the RASS group was significantly lower than the SAS group(P<0.05).Conclusion In ICU severe pneumonia patients with mechanical ventilation sedation score application,RASS sedation score effect is better,it is worthy of further study and promotion in the future clinical work.