神经重症患者镇痛镇静治疗中国专家共识(2023)  

Chinese expert consensus on sedation and analgesia for neurocritical care patients (2023)

作　　者：国家神经系统疾病医疗质量控制中心神经重症亚专业工作组 中国病理生理学会危重病医学专业委员会 《神经重症患者镇痛镇静治疗中国专家共识》工作组 周建新 张琳琳 刘帅 王淑雅 National Center for Healthcare Quality Management in Neurological Diseases;Chinese Society of Critical Care Medicine;Working Group of the Chinese Expert Consensus on Sedation and Analgesia for Neurocritical Care Patients;Zhou Jianxin;Zhang Linlin(不详;Department of Critical Care Medicine,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Critical Care Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]不详 [2]首都医科大学附属北京世纪坛医院重症医学科,北京100038 [3]首都医科大学附属北京天坛医院重症医学科,北京100070

出　　处：《中华危重病急救医学》2023年第9期897-918,共22页Chinese Critical Care Medicine

基　　金：北京市卫生健康科技成果和适宜技术推广项目(BHTPP2022026);首都临床诊疗技术研究及转化应用项目(Z201100005520050)。

摘　　要：镇痛镇静治疗在神经重症领域具有重要作用,但对其评估、实施、减停等具体实践仍存在一定争议.随着神经重症医学的发展、循证医学证据的更新和新型镇痛镇静药物的上市,考虑到我国神经重症从业人员对镇痛镇静认知和实践的差异,由国家神经系统疾病医疗质量控制中心神经重症亚专业工作组、中国病理生理学会危重病医学专业委员会组织全国本领域内专家组成《神经重症患者镇痛镇静治疗中国专家共识》工作组,基于现有的循证医学证据,对《重症脑损伤患者镇痛镇静专家共识》(2013年版)进行了更新,针对神经重症患者镇痛镇静治疗的目的、镇痛镇静治疗过程中的监测、镇痛镇静药物选择,以及镇痛镇静治疗在难治性颅内高压和目标温度管理中的应用等5个方面的18个问题,共给出31条推荐意见,旨在指导临床诊疗,提高神经重症医疗质量,改善神经重症患者预后.Sedation and analgesia therapy play important roles in neurocritical care,but there are still some controversies regarding its assessment,implementation,and reduction.With the development of neurocritical care medicine,the update of evidence-based medicine and the marketing of new analgesic and sedative drugs,considering the differences in the cognition and practice of analgesic and sedative medicine among neurocritical care practitioners in China,the National Center for Healthcare Quality Management in Neurological Diseases and Chinese Society of Critical Care Medicine organized experts in this fields to form a Working Group of the Chinese Expert Consensus on Sedation and Analgesia for Neurocritical Care Patients.Based on existing evidence-based medical evidence,the expert group updated the Expert consensus on sedation and analgesia for patients with severe brain injury(2013).The update focused on 5 domains involving 18 questions related to analgesic and sedative therapy for neurocritical care patients,including the purpose of analgesic and sedative therapy,monitoring during analgesic and sedative therapy,drug selection,and the application for refractory intracranial hypertension and targeted temperature management.A total of 31 recommendations were provided on these topics.This update aimed to renew the existing evidence-based consensus to guide clinical diagnosis and treatment,improve the quality of neurocritical care and enhance outcomes of neurocritical patients.

关 键 词：神经重症 镇痛 镇静 谵妄 专家共识 

分 类 号：R741[医药卫生—神经病学与精神病学]