早期目标导向型镇静策略对术后机械通气患者的临床效果观察  

Clinical effect of early goal-directed sedation on postoperational patients with mechanical ventilation

作　　者：舒开丽 燕朋波 曹文理 李国锋 SHU Kai-li;YAN Peng-bo;CAO Wen-li(Department of Respiratory and Critical Care Medicine,Tianjin Beichen Hospital,Tianjin(300400),China)

机构地区：[1]天津市北辰医院呼吸与危重症医学科,天津300400

出　　处：《中国中西医结合外科杂志》2023年第1期34-37,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市北辰区科技计划项目(SHGY-2020028)。

摘　　要：目的:探讨早期目标导向型镇静策略(EGDS)治疗用于重症监护病房(ICU)机械通气患者的临床效果观察。方法:选取2016年1月—2021年6月我院收治的84例术后带气管插管需继续行机械通气(MV)治疗的非昏迷ICU患者,按照随机数字表法分为治疗组(n=42)和对照组(n=42)。治疗组以右美托咪定作为主要镇静剂,丙泊酚辅助微调镇静的EGDS对ICU机械通气患者进行治疗;对照组以咪达唑仑作为镇静剂进行治疗。结果:与对照组相比,EGDS可提高48 h内达到浅镇静目标(RASS评分-2~+1)的比例、24 h自主呼吸试验(SBT)通过率,减少患者MV时间、ICU入住时间、住院时间及谵妄的发生率(P<0.05)。结论:在早期镇痛基础上应用以右美托咪定为主导、丙泊酚为辅助微调的EGDS方案具有较好的安全性和有效性。Objective To investigate the clinical effect of early goal-directed sedation strategy(EGDS)in patients with intensive care unit(ICU)mechanical ventilation.Methods From January 2016 to June 2021,84non comatose patients with ICU who need to continue mechanical ventilation(MV)after endotracheal intubation were randomly divided into experimental group and control group.In the experimental group,dexmedetomidine was used as the main sedative and propofol assisted fine-tuning sedation;Midazolam was used as sedative in the control group.Results Compared with the control group,EGDS could increase the proportion of reaching the goal of shallow sedation(RASS score-2~+1)within 48 hours and the passing rate of 24-hour spontaneous breathing test(SBT),and reduce the time of MV,ICU hospitalization,hospitalization and delirium(P<0.05).Conclusion On the basis of early analgesia,the EGDS scheme dominated by dexmedetomidine and assisted by propofol has good safety and effectiveness.

关 键 词：早期目标导向镇静 右美托咪定 咪达唑仑 机械通气 

分 类 号：R47[医药卫生—护理学]