人文关怀理念在ICU机械通气患者镇痛镇静的护理实践

Nursing practice of humanistic care concept in analgesia and sedation of ICU patients with mechanical ventilation

目的探讨人文关怀理念在ICU机械通气患者镇痛镇静中的应用方法及效果。方法选取贺州市人民医院ICU 2018年1~12月收治的64例机械通气患者作为对照组,选取贺州市人民医院2019年1~12月收治的69例机械通气患者作为研究组。对照组实施常规护理及镇痛镇静护理,研究组在常规护理基础上融入人文关怀理念。比较两组患者的镇痛镇静药物应用剂量、睡眠质量(RCSQ量表)、机械通气时间、ICU住院时间及谵妄发生率。结果研究组的芬太尼及右美托咪定ICU期间的日平均剂量及总剂量低于对照组,差异有统计学意义(P<0.01);研究组RCSQ量表的睡眠深度、入睡难度、觉醒次数、再入睡难度及整体睡眠质量得分高于对照组,差异有统计学意义(P<0.05);两组的机械通气时间比较,差异无统计学意义(P>0.05);研究组的ICU住院时间短于对照组,差异有统计学意义(P<0.05);研究组的谵妄发生率低于对照组,差异有统计学意义(P<0.05)。结论人文关怀理念在ICU机械通气患者应用能够降低镇痛镇静药物应用量,提升患者睡眠质量,降低谵妄发生率,缩短ICU住院时间。

Objective To explore the application method and effect of humanistic care concept in analgesia and sedation of ICU patients with mechanical ventilation.Methods A total of 64 patients with mechanical ventilation in ICU of People′s Hospital of Hezhou City from January to December 2018 were selected as the control group,and 69 patients with mechanical ventilation in ICU of People′s Hospital of Hezhou City from January to December 2019 were selected as the study group.The control group was given routine nursing and analgesia sedation nursing,while the study group was given humanistic care concept on the basis of routine nursing.The dosage of analgesic and sedative drugs,sleep quality(RCSQ),duration of mechanical ventilation,length of ICU stay and the incidence of delirium were compared between the two groups.Results The average daily dose and the total dose of Fentanyl and Dexmedetomidine in the study group were lower than those in the control group,and the differences were statistically significant(P<0.01).The scores of sleep depth,difficulty of falling asleep,times of awakening,difficulty of falling asleep again and overall sleep quality of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).There was no significant difference in mechanical ventilation time between the two groups(P>0.05).The length of ICU stay in the study group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The incidence of delirium in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of humanistic care concept in ICU patients with mechanical ventilation can reduce the dosage of analgesic and sedative drugs,improve sleep quality,reduce the incidence of delirium,and shorten the length of ICU stay.