镇痛镇静舒适化护理在重症肺炎机械通气患者中的应用

Application of comfort nursing using analgesia and sedation in patients with severe pneumonia underwent mechanical ventilation

目的 探讨重症肺炎机械通气患者采用镇痛镇静舒适化护理干预的效果。方法 选取2019年6月—2022年1月郑州大学第一附属医院重症监护室(ICU)收治的126例重症肺炎机械通气患者,采用随机数字表法分为观察组和对照组,每组63例。对照组患者入科后给予标准镇痛镇静护理管理,观察组患者入科后给予镇痛镇静舒适化护理管理,比较2组患者住院相关指标,镇痛镇静类药物使用情况、住院期间不良反应发生情况及转归情况。结果 观察组患者机械通气时间、ICU住院时间、总住院时间均短于对照组,差异均有统计学意义(P<0.05)。观察组患者ICU住院期间咪达唑仑注射液与盐酸吗啡注射液使用总剂量及平均剂量均小于对照组,差异均有统计学意义(P<0.05)。观察组患者ICU住院期间不良反应发生率为4.76%(3/63),低于对照组的15.87%(10/63),差异有统计学意义(χ^(2)=4.203,P=0.040)。观察组患者好转后转科比例为96.83%(61/63),高于对照组的90.48%(57/63),但差异无统计学意义(χ^(2)=1.201,P=0.273)。结论 重症肺炎机械通气患者采用镇痛镇静舒适化护理管理干预,可明显缩短患者机械通气时间,减少镇静、镇痛类药物使用剂量,降低不良反应发生风险。

Objective This paper aims to investigate the effect of comfort nursing using analgesia and sedation intervention in patients with severe pneumonia who underwent mechanical ventilation.Methods From June 2019 to January 2022,126 mechanically ventilated patients with severe pneumonia admitted to the intensive care unit(ICU)of the First Affiliated Hospital of Zhengzhou University were randomly assigned to an observation group and a control group,with 63 cases in each group.The patients in the control group received standard nursing using analgesia and sedative management after admission,while the patients in the observation group were given comfort nursing using analgesia and sedation management after admission.The relevant indicators of hospitalization,the use of analgesic and sedative drugs,and the occurrence and outcome of adverse reactions during hospitalization were compared between the two groups.Results The duration of mechanical ventilation,length of ICU stay,and total hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).The total dose and average dose of midazolam injection and morphine hydrochloride injection used during ICU stay in the observation group were significantly less than those in the control group(P<0.05).The incidence rate of adverse reactions during ICU stay in the observation group was 4.76%(3/63),which was lower than that[15.87%(10/63)]in the control group,with statistical significance(χ^(2)=4.203,P=0.040).The proportion of patients transferred to other departments after improvement in the observation group was 96.83%(61/63),which was higher than that[90.48%(57/63)]in the control group,but the difference was not statistically significant(χ^(2)=1.201,P=0.273).Conclusion Comfort nursing using analgesia and sedation management intervention in patients with severe pneumonia who underwent mechanical ventilation can markedly shorten the duration of mechanical ventilation,reduce the dose of sedative and analgesic drugs,and reduce the risk of adverse reactions.