集束化护理干预对重症监护室机械通气患者谵妄的影响  

Effect of cluster nursing intervention on delirium of patients with mechanical ventilation in intensive care unit

作　　者：杨杰[1] 党永霞[1] 王毅[1] 杨华山[2] 别良玉[3] YANG Jie;DANG Yong-xia;WANG Yi;YANG Hua-shan;BIE Liang-yu(Department of Critical Care Medicine,Nanyang Central Hospital,Nanyang 473009,Henan Province,China;College of Nursing,Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Oncology,Henan Cancer Hospital,Zhengzhou 450008,Henan Province,China)

机构地区：[1]南阳市中心医院重症医学科,河南南阳473009 [2]郑州大学护理学院,河南郑州450052 [3]河南省肿瘤医院肿瘤科,河南郑州450008

出　　处：《新乡医学院学报》2019年第11期1081-1083,共3页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020504)

摘　　要：目的探讨集束化护理干预对重症监护室(ICU)机械通气患者谵妄的影响。方法选择2018年1月至2019年2月南阳市中心医院ICU行机械通气患者90例,根据护理方案分为观察组和对照组,每组45例。对照组患者给予常规重症监护护理措施,观察组患者在常规护理基础上给予集束化护理干预。采用重症监护谵妄筛查检查表(ICDSC)评估患者ICU住院期间谵妄发生情况,统计谵妄发生率、初次谵妄发生时间和谵妄持续时间;记录2组患者机械通气时间、ICU住院时间及ICU治疗费用。结果2组患者入住ICU 8 h内谵妄发生率比较差异无统计学意义(P>0.05),观察组患者入住ICU 8 h以后谵妄发生率及总发生率均低于对照组(P<0.05)。2组患者初次谵妄发生时间比较差异无统计学意义(P>0.05),观察组患者每次谵妄持续时间短于对照组(P<0.05)。观察组患者ICU住院时间短于对照组,ICU治疗费用少于对照组(P<0.05);2组患者机械通气时间比较差异无统计学意义(P>0.05)。结论集束化护理干预可降低ICU行机械通气患者谵妄发生率,缩短谵妄持续时间,促进患者康复,减少患者医疗费用。Objective To investigate the effect of cluster nursing intervention on delirium of patients with mechanical ventilation in intensive care unit(ICU).Methods Ninety patients with mechanical ventilation in ICU of Nanyang Central Hospital from January 2018 to February 2019 were selected and divided into observation group and control group according to the nursing program,forty-five patients in each group.The patients in the control group were given routine intensive care measures,while the patients in the observation group were given cluster nursing intervention on the basis of routine care.The occurrence of delirium of patients in ICU was assessed by intensivecare delirium screening checklist(ICDSC);and the incidence of delirium,the time of first delirium and the duration of delirium were counted.The mechanical ventilation time,ICU hospitalization time and ICU treatment cost were recorded in the two groups.Results There was no significant difference in the incidence of delirium between the two groups within 8 hours of ICU admission(P>0.05).The incidence of delirium within 8 hours of ICU admission and the total incidence of delirium in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the time of first delirium between the two groups(P>0.05).The duration of delirium in the observation group was shorter than that in the control group(P<0.05).Compared with the control group,the ICU hospitalization time was shorter and the ICU treatment cost was less in the observation group(P<0.05).There was no significant difference in the mechanical ventilation time between the two groups(P>0.05).Conclusion The cluster nursing intervention can reduce the incidence of delirium in patients with mechanical ventilation in ICU,shorten the duration of delirium,promote the rehabilitation of patients,and reduce the medical expenses of patients.

关 键 词：重症监护室 机械通气 集束化护理 谵妄 

分 类 号：R473[医药卫生—护理学]