小剂量丙泊酚联合缩减约束方案预防ICU气管插管患者非计划性拔管

The feasibility of low-dose propofol combined with reduced restraint scheme in the prevention of unplanned extubation in patients undergoing endotracheal intubation in ICU

目的探讨小剂量丙泊酚联合缩减约束方案用于预防ICU气管插管患者非计划性拔管。方法回顾性分析2017年1月至2018年1月收治的气管插管的ICU患者129例,采用常规小剂量丙泊酚镇静方案,作为对照组。另回顾性分析2019年1月至2020年1月收治的气管插管的ICU患者132例,采用小剂量丙泊酚镇静联合缩减约束方案,作为观察组。观察2组患者约束前后躁动评分、约束以及非计划拔管情况、护理满意度。结果术前2组患者躁动评分比较差异无统计学意义(P>0.05),约束后2组患者躁动评分较约束前降低,且观察组患者躁动评分显著低于对照组(P<0.05);观察组患者身体约束、非计划拔管率及皮肤损伤发生率显著低于对照组(P<0.05);观察组患者健康教育、心理支持以及总满意度明显高于对照组,差异有统计学意义(P<0.05)。结论小剂量丙泊酚联合缩减约束方案能有效改善ICU气管插管患者躁动评分及约束情况,减少患者非计划性拔管,值得推广。

Objective To investigate the feasibility of low-dose propofol combined with reduced restraint scheme in the prevention of unplanned extubation in patients undergoing endotracheal intubation in ICU.Methods A total of 129 patients who received endotracheal intubation in ICU and treated by conventional low-dose propofol sedation scheme in our hospital from January 2017 to January 2018 were enrolled as control group,and the other 132 patients who received endotracheal intubation in ICU and treated by low-dose propofol combined with reduced restraint scheme from January 2019 to January 2020 were enrolled as observation group.The general data(age,gender,weight,education level,disease type),and the restlessness score,restraint and unplanned extubation,and nursing satisfaction degree were observed and comapred between the two groups.Results Before surgery,there were no significant differences in restlessness scores between the two groups(P>0.05).After treatment,the restlessness scores in both groups were decreased,moreover,which in observation group were significantly lower than those in control group(P<0.05).The incidence rates of body constraint,unplanned extubation and skin injury in observation group were significantly lower than those in control group(P<0.05),however,the health education,psychological support and overall service satisfaction degree in observation group were significantly higher than those in control group(P<0.05).Conclusion The low dose propofol combined with reduced restraint scheme can effectively improve the agitation scores and restraint status of patients with endotracheal intubation in ICU,and reduce unplanned extubation,thus,which is worthy of promotion in clinical practice.