镇静镇痛集束护理对ICU气管插管患者谵妄的影响  

Effect of Bundle Nursing of Sedation and Analgesia on Delirium of Trachea Intubation Patients in ICU

作　　者：孙福月[1] 杨宁[1] 李超[1] 麻苗 SUN Fu-yue;YANG Ning;LI Chao;MA Miao(Dept. of Respiratory Disease and Critical Care Medicine, Affiliated Hospital of Logistic University of People＇s Armed Police Force, Tianjin 300162, China)

机构地区：[1]武警后勤学院附属医院呼吸与重症医学科,天津300162

出　　处：《护理学报》2018年第10期58-61,共4页Journal of Nursing（China）

基　　金：国家自然科学基金(31200809);武警后勤学院附属医院种子基金(FYQ201606)

摘　　要：目的探讨镇静镇痛集束护理策略对ICU气管插管患者谵妄的影响。方法依据便利抽样法,选取2017年1—8月转入ICU的80例行气管插管患者,作为集束化组,在常规护理的同时进行规范化镇静镇痛集束护理措施。另取同期转入ICU的80例气管插管患者,作为对照组,行常规护理。记录患者性别、年龄、疾病诊断例数分布、使用镇静镇痛药的情况、急性生理和慢性健康评分(Acute Physiology and Chronic Health Evaluation,APACHEⅡ)、ICU住院时间、机械通气时间、谵妄发生率、谵妄类型(安静型、躁动型或混合型)及持续时间。结果 2组患者的性别构成、平均年龄、疾病诊断例数分布、使用镇静镇痛药的情况、APACHEⅡ评分、ICU住院时间和机械通气时间比较,差异均无统计学意义(P>0.05);集束化组谵妄的发生率及谵妄的构成类型与对照组相比,差异无统计学意义(P>0.05),但谵妄持续时间显著缩短(P<0.05)。结论镇静镇痛集束的应用可有效降低气管插管患者的谵妄持续时间,可能对改善预后起到积极作用。Objective To explore the effect of bundle nursing of sedation and analgesia on delirium of trachea intubation patients in ICU. Methods With convenient sampling, 80 trachea intubation patients from January to August 2017 were enrolled in the observation group, in which bundle nursing of standardized sedation and analgesia was performed in addition to conventional nursing and another 80 trachea intubation patients in the control group, in which convention nursing was performed. General information of the patients, number distribution of disease diagnosis, medication of sedation and analgesia, Acute Physiology and Chronic Health Evaluation（APACHE Ⅱ） score, stay of length in ICU, duration of mechanical ventilation, incidence, type and duration of delirium in the 2 groups were recorded and compared. Results There was no statistical significance regarding to patients ＇ general information,number distribution of disease diagnosis, medication of sedation and analgesia, APACHE Ⅱ score, stay of length in ICU and duration of mechanical ventilation in the 2 groups（P〈0.05）. The incidence and type of delirium showed no statistical significance in the 2 groups（P〈0.05） but the duration of delirium in the observation group was obviously shortened（ P〈0.05）. Conclusion Bundle nursing of sedation and analgesia is effective for shortening the duration of delirium for trachea intubation patients in ICU and plays a positive role in the prognosis of the patients.

关 键 词：镇静镇痛集束 谵妄 气管插管 

分 类 号：R473[医药卫生—护理学]