早期目标导向镇静对ICU机械通气患者睡眠质量和认知功能的影响  

The Effect of Early Goal-oriented Sedation on Sleep Quality and Cognitive Function in ICU Mechanically Ventilated Patients

作　　者：陈跃进 许丹香 黄庭龙[1] CHEN Yuejin;XU Danxiang;HUANG Tinglong(Second Affiliated Hospital of Fujian Medical University,Quanzhou362200,China)

机构地区：[1]福建医科大学附属第二医院,泉州362200

出　　处：《世界睡眠医学杂志》2024年第3期684-687,共4页World Journal of Sleep Medicine

摘　　要：目的:分析早期目标导向镇静(EGDS)在重症监护病房(ICU)机械通气患者中的应用效果。方法:选取2023年2月至2024年1月福建医科大学附属第二医院收治的ICU气管插管机械通气患者80例作为研究对象,按照随机数字表法分为观察组和对照组,每组40例。观察组给予早期目标导向镇静(EGDS)干预,对照组给予传统标准镇静(STDS)干预。通过多导睡眠图(PSG)监测评价2组患者的睡眠质量,采用简易精神状态量表(MMSE)评估2组患者的认知功能,采用ICU意识模糊评估表(CAM-ICU)比较2组患者的谵妄症状,同时比较2组患者的康复情况。结果:干预后,观察组N1期占有效睡眠百分比(N1%)低于对照组,N3期占有效睡眠百分比(N3%)、快速眼球运动期占有效睡眠百分比(REM%)与睡眠效率(SE)均显著高于对照组,2组在转出ICU时MMSE评分均有所升高,且观察组显著高于对照组,观察组谵妄发生率显著低于对照组,观察组机械通气时间、ICU住院时间均短于对照组,差异无统计学意义(P>0.05)。结论:EGDS可显著改善ICU机械通气患者的睡眠质量,促进认知功能恢复,加快患者的康复进程,值得临床推广应用。Objective:To analyze the application effect of early goal-directed sedation(EGDS)in mechanically ventilated patients in the intensive care unit(ICU).Methods:The study subjects were selected as the study subjects of 80 ICU patients with tracheal intubation mechanical ventilation admitted to the Second Affiliated Hospital of Fujian Medical University from February 2023 to January 2024.Using a random number table method,they were randomly divided into an observation group and a control group,with 40 cases in each group.The observation group received early rise goal-directed sedation(EGDS)intervention,while the control group received traditional standard sedation(STDS)intervention.The sleep quality of the two groups of patients was evaluated through polysomnography(PSG)monitoring.The cognitive function of the two groups of patients was evaluated using the Mini Mental State Scale(MMSE).The delirium symptoms of the two groups of patients were compared using the ICU Ambiguity Assessment Form(CAM-ICU),and the rehabilitation status of the two groups of patients was also compared.Results:After the intervention,the percentage of adequate sleep(N1%)in the observation group was lower than that in the control group,while the percentage of adequate sleep(N3%)in the N3 phase,the percentage of proper sleep(REM%)in the rapid eye movement phase,and the sleep efficiency(SE)were significantly higher than those in the control group.The MMSE score in the observation group was higher than that in the control group,and the mechanical ventilation time and ICU hospitalization time in the observation group were shorter than those in the control group.The differences between the two groups were statistically significant(P<0.05).Conclusion:EGDS can significantly improve the sleep quality of mechanically ventilated patients in the ICU,promote cognitive function recovery,and accelerate the recovery process of patients.It is worthy of clinical promotion and application.

关 键 词：重症监护病房 机械通气 早期目标导向镇静 睡眠 多导睡眠图 认知功能 康复进程 

分 类 号：R248.1[医药卫生—中医临床基础] R338.63[医药卫生—中医学]