镇静镇痛集束化护理干预在预防脑外伤后机械通气患者谵妄中的效果

Effect of cluster analgesia sedation nursing intervention on preventing delirium in patients with mechanical ventilation after traumatic brain injury

目的探讨镇静镇痛集束化护理干预在预防脑外伤后机械通气患者谵妄中的效果。方法选取2018年4月至2020年12月本院收治的100例脑外伤后行机械通气的患者作为研究对象,按照随机数字表法分为对照组与观察组,每组50例。对照组给予常规护理,观察组在常规护理基础上给予镇静镇痛集束化护理。比较两组年龄、性别、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、谵妄发生率、谵妄初始发生时间和持续时间、机械通气时间及重症加护室(ICU)住院时间。结果观察组谵妄发生率低于对照组,差异有统计学意义(P<0.05),两组初次发生谵妄时间比较差异均无统计学意义,观察组谵妄持续时间短于对照组,差异有统计学意义(P<0.05);观察组ICU住院时间短于对照组,差异有统计学意义(P<0.05),两组机械通气时间比较差异无统计学意义。结论镇静镇痛集束化护理能明显降低脑外伤后机械通气患者谵妄发生率和持续时间,缩短ICU住院时间,值得临床推广应用。

Objective To explore the effect of cluster analgesia sedation nursing intervention on preventing delirium in patients with mechanical ventilation after traumatic brain injury.Methods 100 patients with mechanical ventilation after traumatic brain injury treated in our hospital from April 2018 to December 2020 were selected as the research subjects,and they were divided into the control group and the observation group according to random number table method,with 50 cases in each group.The control group was given routine nursing,and the observation group was given cluster analgesia sedation nursing intervention on the basis of routine nursing,the incidence of delirium of acute physiology and chronic health evaluation scoring system(APACHEⅡ)score was compared between the two groups.Results The incidence of delirium in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05),there was no significant difference in the time of initial delirium between the two groups,and the duration of delirium in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05).The length of ICU stay in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05),but there was no statistically significant difference in mechanical ventilation time between the two groups.Conclusion Cluster analgesia sedation nursing can significantly reduce the incidence and duration of delirium in patients with mechanical ventilation after brain injury,shorten the length of ICU stay,and is worthy of clinical promotion and application.