持续浅镇静目标导向应用于ICU机械通气患者对通气治疗效果及不良反应发生率的影响  

Effects of sustained shallow sedation targeting on ventilation therapy and adverse reactions in ICU patients with mechanical ventilation

作　　者：张艳[1] 仲爱玲 陈月 Zhang Yan;Zhong Ailing;Chen Yue(Surgical Department of People′s Hospital, Haian County, Haian 226600, China)

机构地区：[1]海安县人民医院外科ICU,江苏南通226600 [2]上海市宝山区中西医结合医院

出　　处：《海军医学杂志》2019年第4期350-353,共4页Journal of Navy Medicine

基　　金：南通市科技计划项目新型临床诊疗技术攻关项目(GJZ16124)

摘　　要：目的探讨持续浅镇静目标导向应用于ICU机械通气患者中对通气治疗、不良反应发生率的影响.方法将2015年6月至2016年6月南通市海安县人民医院收治的行常规镇静方案的ICU机械通气患者59例纳入对照组,将2016年7月至2017年7月该院收治的行持续浅镇静目标导向方案的ICU机械通气患者59例纳入研究组.比较2组镇静药物使用剂量、通气治疗效果和不良反应发生率.结果研究组丙泊酚给药剂量、丙泊酚总剂量、右美托咪定给药剂量、右美托咪定总剂量、咪唑安定人均总剂量均少于对照组,差异有统计学意义(P<0.05).研究组机械通气时间、入住ICU时间、住院时间均短于对照组,差异有统计学意义(P<0.05);研究组呼吸机相关性肺炎、气管切开发生率低于对照组,差异有统计学意义(P<0.05);研究组谵妄发生率低于对照组,差异有统计学意义(P<0.05).结论持续浅镇静目标导向应用于ICU机械通气患者中可明显减少镇静药物使用剂量,缩短机械通气时间,降低患者机械通气不良事件和谵妄发生率,值得推广.Objective To investigate the effects of sustained shallow sedation targeting on ventilation therapy and incidence of adverse reactions in ICU patients with mechanical ventilation.Methods Fifty-nine ICU patients with mechanical ventilation, who underwent routine sedation in the hospital from June 2015 to June 2016, were included in the control group, while another 59 ICU patients with mechanical ventilation, who underwent sustained shallow sedation targeting in the hospital from July 2016 to July 2017, were enrolled in the study group. The sedative dosage, ventilation therapy efficacy and adverse reactions were compared between the patients of the 2 groups.Results The propofol dosage, propofol total dosage, dexmedetomidine dosage, dexmedetomidine total dosage and midazolam per capita total dosage in the study group were all lower than those in the control group, and statistical significance could be noted, when comparisons were made between them ( P <0.05). The duration of mechanical ventilation, the length of ICU stay and hospitalization days of the study group were all shorter than those of the control group, and statistical significance could be found, when comparisons were made between them ( P <0.05). The rates of ventilator-associated pneumonia and tracheostomy in the study group were all lower than those in the control group, with statistical significance ( P <0.05). The incidence of delirium in the study group was lower than that in the control group, also with statistical significance ( P <0.05). Conclusion The application of sustained shallow sedation targeting in the ICU patients with mechanical ventilation could significantly reduce the dosage of sedative drugs, shorten the duration of mechanical ventilation and reduce the rates of adverse events related with mechanical ventilation and delirium. Therefore, it is worth further promotion.

关 键 词：持续浅镇静目标导向 ICU 机械通气 治疗效果 不良反应 

分 类 号：R473[医药卫生—护理学]