深镇静与浅镇静对ICU机械通气患者预后的影响比较

Comparison of deep sedation and shallow sedation on prognosis of ICU patients with mechanical ventilation

目的比较深镇静与浅镇静对ICU机械通气患者预后的影响。方法选取贵阳市云岩区黔灵医院2020年3—9月收治的ICU机械通气患者94例,按照Richmond躁动-镇静评分(RASS)分为早期浅镇静组和深期浅镇静组,各47例。所有患者均采用镇静干预。比较2组机械通气时间、拔管时间、住院时间,病死率、谵妄以及物理约束率,并比较2组麻醉前后血氧饱和度(SaO2)、心率。结果浅镇静组机械通气时间、拔管时间、住院时间短于深镇静组,病死率、谵妄以及物理约束率低于深镇静组(P<0.05)。麻醉前2组SaO2、心率比较,差异无统计学意义(P>0.05);麻醉后浅镇静组SaO2、心率低于深镇静组(P<0.05)。结论浅镇静可缩短ICU机械通气患者住院和拔管时间,同时降低病死率,但深镇静可获得更佳镇静效果,因此采用何种方式镇静需依据患者需求。

Objective To compare the effect of deep sedation and shallow sedation on the prognosis of ICU patients with mechanical ventilation.Methods A total of 94 cases of patients with mechanical ventilation in ICU were selected from March to September 2020 in Guiyang Yunyan Qianling Hospital,which were divided into early shallow sedation group and deep shallow sedation group according to Richmond agitation sedation score(RASS),47 cases in each group.All patients were given sedation intervention.The mechanical ventilation time,extubation time,hospital stay,mortality,delirium and physical restraint rate were compared between the two groups,and the blood oxygen saturation(SaO2)and heart rate before and after anesthesia were compared between the two groups.Results The mechanical ventilation time,extubation time and hospital stay time of the shallow sedation group were shorter than the deep sedation group,and the mortality,delirium and physical restraint rate of the shallow sedation group were lower than the deep sedation group(P<0.05).There was no significant difference in SaO2 and heart rate between the two groups before anesthesia(P>0.05);SaO2 and heart rate in shallow sedation group were lower than those in deep sedation group after anesthesia(P<0.05).Conclusion Shallow sedation can shorten the hospitalization and extubation time of ICU patients with mechanical ventilation,and reduce the mortality,but deep sedation can obtain better sedation effect,so the sedation method should be based on the needs of patients.