对儿科重症监护病房行机械通气的患儿应用以护士为主导的早期目标导向镇静策略的价值分析

Analysis of the Value of Applying a Nurse-led Early Goal-directed Sedation Strategy to Children Undergoing Mechanical Ventilation in a Pediatric Intensive Care Unit

目的:探讨以护士为主导的早期目标导向镇静(EGDS)策略在儿科重症监护病房(PICU)行机械通气患儿中的应用效果。方法:选取2021年4月-2022年3月于连云港市第一人民医院PICU行机械通气的患儿85例作为研究对象,采用抽签法随机分为对照组(n=41)和试验组(n=44)。对照组采用常规镇静策略,试验组采用以护士为主导的EGDS策略。比较两组谵妄发生率、机械通气时间和PICU住院时间。结果:试验组谵妄发生率较对照组低(P=0.020)。两组非计划性拔管发生率比较,差异无统计学意义(P>0.05)。试验组机械通气时间、PICU住院时间较对照组短(P<0.05)。结论:以护士为主导的EGDS策略在PICU机械通气患儿中的应用效果较好,能有效降低患儿谵妄发生率,缩短机械通气时间和PICU住院时间,促进患儿康复。

Objective:To investigate the effectiveness of nurse-led early goal-directed sedation(EGDS)strategy in children undergoing mechanical ventilation in pediatric intensive care unit(PICU).Methods:Eighty-five children who were mechanically ventilated in the PICU of Lianyungang First People's Hospital from April 2021 to March 2022 were selected as the study subjects,and were randomly divided into the control group(n=41)and the experimental group(n=44)using the lottery method.Conventional sedation strategy was used in the control group and nurse-led EGDS strategy was used in the experimental group.The incidence of delirium,duration of mechanical ventilation and PICU stay were compared between the two groups.Results:The incidence of delirium in the experimental group was lower than that in the control group(P=0.020);the difference in the incidence of unplanned extubation between the two groups was not statistically significant(P>0.05);the mechanical ventilation time and PICU hospital stay time in the experimental group were shorter than that in the control group(P<0.05).Conclusion:The nurse-led EGDS strategy is more effective in children with mechanical ventilation in PICU,which can effectively reduce the incidence of delirium,shorten the time of mechanical ventilation and PICU hospital stay,and promote the recovery of the children.