以护士为主导的舒化浅镇静在ICU机械通气患者中的应用  

Application of Nurse-led Shuhua Shallow Sedation in Patients with Mechanical Ventilation in ICU

作　　者：廖少梅 Liao Shaomei(Sihui People’s Hospital,Sihui 526200)

机构地区：[1]四会市人民医院,广东四会526200

出　　处：《黑龙江医药》2024年第3期702-705,共4页Heilongjiang Medicine journal

基　　金：肇庆市科技创新指导类项目(项目编号:202004031371)。

摘　　要：目的:探究以护士为主导的舒化浅镇静在ICU机械通气患者中的应用价值。方法:收集四会市人民医院在2021年5月—2023年10月期间入院治疗的非急性呼吸窘迫综合征(ARDS)机械通气需镇痛镇静患者60例,按照电脑数字表法随机分为两个组别,对照组(n=30)与干预组(n=30)。对照组予以常规镇静镇痛管理;干预组予以忽视为主导的舒化浅镇静(eCASH)、镇痛管理。比较两组机械通气时间、ICU入住天数、一次性成功拔管率;比较两组谵妄发生率、ICU入住期间不良事件发生率;比较预后指标[急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)、Barthel指数评定量表(BI指数)评分]情况。结果:干预组的机械通气时间、ICU入住天数均较对照组短,而一次性成功拔管率为96.67%,较对照组的63.33%高(P<0.05)。干预组谵妄发生率、ICU入住不良事件发生率均较对照组低(P<0.05)。干预组转出ICU时APACHEⅡ评分较对照组低(P<0.05);转出ICU时观察组BI指数评分较对照组的高(P<0.05)。结论:机械通气患者在ICU入住期间实施以护士为主导的舒化浅镇静管理,利于缩减机械通气时间以及ICU入住天数,提升一次性成功拔管率,且安全性高,能降低谵妄发风险,改善患者疾病严重程度以及日常生活能力,值得推广。Objective:To explore the application value of nurse-led Shuhua shallow sedation in patients with mechanical ventilation in ICU.Methods:A total of 60 patients with non-acute respiratory distress syndrome(ARDS)who needed analgesia and sedation through mechanical ventilation admitted to Sihui People’s Hospital from May 2021 to October 2023 were collected and randomly divided into two groups according to digital table method:control group(n=30)and intervention group(n=30).The control group was given routine sedation and analgesia management;In the intervention group,eCASH and analgesic management were ignored.Mechanical ventilation time,ICU stay days and one-time successful extubation rate were compared between the two groups.The incidence of delirium and adverse events during ICU stay were compared between the two groups.The outcomes of acute physiological function and Chronic Health Status Scoring System II(APACHEⅡ)and Barthel Index Rating Scale(BI Index)were compared.Results:The mechanical ventilation time and ICU stay days in the intervention group were shorter than those in the control group,and the one-time successful extubation rate was 96.67%higher than 63.33%in the control group(P<0.05).The incidence of delirium and ICU admission adverse events in the intervention group were lower than those in the control group(P<0.05).The APACHEⅡscore of the intervention group was lower than that of the control group when transferred out of ICU(P<0.05).The BI index score of the observation group was higher than that of the control group(P<0.05).Conclusion:The implementation of nurse-led Shuhua shallow sedation management in patients with mechanical ventilation during ICU stay is beneficial to reducing mechanical ventilation time and ICU stay days,increasing one-time successful extubation rate,and has high safety,can reduce the risk of delirium,improve the severity of disease and daily living ability of patients,and is worthy of promotion.

关 键 词：以护士为主导 舒化浅镇静 ICU 机械通气 

分 类 号：R563.8[医药卫生—呼吸系统] R473[医药卫生—内科学]