三级谵妄流程管理对PICU患儿预后影响研究

Study on the impact of the management of three-level delirium process on the prognosis of PICU children

目的探究三级谵妄流程管理对儿科重症监护病房(PICU)患儿预后的影响。方法选取2019年6月-2020年6月期间西南医科大学附属医院儿科接收治疗的118例PICU患儿为研究对象,采用随机数字表法分为对照组(常规干预)和观察组(三级谵妄流程管理),各59例。对PICU患儿谵妄情况、干预前后两组ICDSC情况、预后及家属满意度比较。结果与对照组相比,观察组患儿的DICU发生率、DICU相关不安全事件、DICU持续时间、PICU住院时间、抢救次数、功能衰竭脏器、MOSF发生率和28d病死率均降低,观察组患儿家属对干预的满意率升高,差异统计学有意义(P<0.05)。与对照组相比,干预前观察组患儿的ICDSC各项症状出现率差异无统计学意义(P>0.05);干预后两组患儿的ICDSC各项症状出现率与干预前比较均降低,且观察组低于对照组,差异统计学有意义(P<0.05)。结论PICU患儿通过三级谵妄流程管理能够有效改善谵妄症状的出现,降低DICU及相关不安全事件的发生,减少PICU内抢救次数,缓解脏器衰竭情况,促进恢复,改善预后,提高家属满意度。

Objective To explore the impact of three-level delirium process management on the prognosis of children in pediatric intensive care unit(PICU).Methods A total of 118 children with PICU who received treatment in the Department of Pediatrics of the Affiliated Hospital of Southwest Medical University from June 2019 to June 2020 were selected as the study subjects.They were divided into control group(routine intervention)and observation group(Grade Ⅲ delirium management)by random number table method,with 59 cases in each group.Compared with delirium in children with PICU,ICDSC situation,prognosis and family satisfaction between two groups before and after intervention.Results Compared with the control group,the incidence of DICU,DICU-related unsafe events,DICU duration,PICU hospitalization time,times of rescue,organ failure,MOSF incidence and 28 d mortality in the observation group were all decreased,and the satisfaction rate of the families of the children in the observation group was increased,and the difference was statistically significant.(P<0.05).Compared with the control group,there was no significant difference in the incidence of ICDSC symptoms in the observation group before intervention(P>0.05).After the intervention,the incidence of ICDSC symptoms in the two groups decreased compared with before the intervention,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05)..Conclusion The three-level delirium process management for PICU children can effectively improve the appearance of delirium symptoms,reduce the occurrence of DICU and related unsafe events,reduce the number of rescues in PICU,alleviate organ failure,promote recovery,improve prognosis,and improve family satisfaction.