音乐疗法干预联合丙泊酚、咪达唑仑镇静对机械通气患者负性情绪及谵妄发生率的影响

Influence of music therapy intervention combined with propofol and midazolam sedation on negative emotion and delirium incidence of mechanical ventilation patients

目的:研究机械通气患者行音乐疗法联合丙泊酚、咪达唑仑镇静干预后负性情绪变化及谵妄发生情况。方法:选取2018年1月至2020年6月在某院治疗的机械通气患者380例,将2018年1月至2019年3月就诊的患者选取190例作为对照组,2019年4月至2020年6月就诊的患者选取190例作为观察组。对照组采用常规管护+丙泊酚、咪达唑仑镇静,观察组在对照组基础上联合音乐疗法干预,两组均干预2周。比较两组干预后机械通气情况、干预前后负性情绪、干预后镇静效果、谵妄及并发症发生情况。结果:干预后观察组机械通气用时、住院时间低于对照组,撤机成功率高于对照组(t=-11.449,-12.474,χ^(2)=15.984;P<0.05);SAS、SDS低于对照组(t=-8.383,-7.458;P<0.05);RSS得分显著高于对照组(t=12.300,P<0.05);咪达唑仑、丙泊酚用药剂量和谵妄发生率显著低于对照组(t=-12.247,-9.758,χ^(2)=18.234;P<0.05);呼吸机相关性肺炎、深静脉血栓、气管切开发生率显著低于对照组(χ^(2)=9.474,8.518,6.919;P<0.05)。结论:音乐疗法干预联合丙泊酚、咪达唑仑镇静对可加快机械通气患者恢复进程、调节负性情绪、镇静效果良好,可降低谵妄发生,安全性较好。

Objective:To study the changes of negative emotion and delirium in mechanically ventilated patients after music therapy combined with propofol and midazolam sedation intervention.Methods:A total of 380 patients with mechanical ventilation treated in our hospital from January 2018 to June 2020 were selected, with 190 patients from January 2018 to March 2019 as control group and 190 patients from April 2019 to June 2020 as observation group.The control group was sedated by routine care+propofol and midazolam, while the observation group was intervened by music therapy on the basis of the control group.Both groups intervened for 2 weeks.Mechanical ventilation, negative emotions before and after intervention, sedation effect, delirium and complications were compared between the two groups.Results:After intervention, the duration of mechanical ventilation and hospitalization in observation group were significantly lower than those in control group, and the success rate of weaning was significantly higher than that in control group(t=-11.449,-12.474;χ^(2)=15.984;P<0.05).SAS and SDS were significantly lower than those in the control group(t=-8.383,-7.458;P<0.05).RSS score was significantly higher than that of control group(t=12.300,P<0.05).The dosage of midazolam and propofol and the incidence of delirium were significantly lower than those in the control group(t=-12.247,-9.758,χ^(2)=18.234;P<0.05).The incidence of ventilator-associated pneumonia, deep vein thrombosis and tracheotomy was significantly lower than that of the control group(χ^(2)=9.474,8.518,6.919;P<0.05).Conclusion:Music therapy intervention combined with propofol and midazolam sedation can speed up the recovery process, regulate negative emotions, and have a good sedative effect, which can reduce the occurrence of delirium and is safe.