缩减约束方案对预防重症监护室脑出血气管插管患者非计划性拔管的作用研究  

Study on the Role of Reduced Restraint Protocol on Preventing Unplanned Extubation in Patients with Cerebral Hemorrhage in Intensive Care Unit

作　　者：庄娜婷 Zhuang Nating(ICU,Jinjiang Hospital(Shanghai Sixth People's Hospital Fujian Hospital),Jinjiang 362000,China)

机构地区：[1]晋江市医院(上海第六人民医院福建医院)ICU,晋江362000

出　　处：《中国医药指南》2024年第21期88-91,共4页Guide of China Medicine

摘　　要：目的探究缩减约束方案在重症监护室(ICU)脑出血气管插管患者中的应用价值。方法纳入晋江市医院2021年10月至2022年12月ICU收治的100例脑出血患者,采用密闭信封法分为对照组(n=50)、研究组(n=50)。对照组行常规约束,研究组实施缩减约束方案。统计两组在ICU期间非计划性拔管发生率、约束情况及皮肤损伤,干预前及干预2周对比焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果研究组非计划性拔管发生率为2.00%,低于对照组的14.00%(χ^(2)=4.891;P<0.05)。研究组皮肤损伤发生率低于对照组(P<0.05)。研究组约束比例少于对照组(P<0.05),约束时间短于对照组(P<0.001)。干预前,两组SAS、SDS评分对比,P>0.05;干预2周后,两组SAS、SDS评分均降低,且研究组SAS、SDS评分低于对照组(P<0.001)。结论针对ICU脑出血气管插管患者实施缩减约束方案可降低非计划性拔管风险,并改善皮肤损伤问题,从而缓解患者负性情绪。Objective To explore the value of restraint reduction in patients with cerebral hemorrhage in intensive care unit(ICU).Methods One hundred patients with cerebral hemorrhage admitted in the ICU from October 2021 to December 2022 were divided into control group(n=50)and study group(n=50)by closed envelope method.The control group underwent routine constraint,and the study group implemented the reduction constraint scheme.The incidence of unplanned extubation,restraint and skin injury during ICU,and Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)scores before intervention and 2 weeks of intervention were counted.Results The incidence of unplanned extubation in the study group was 2.00%,lower than the control group's 14.00%(χ^(2)=4.891;P<0.05).The incidence of skin injury in the study group was lower than that in the control group(P<0.05).The constraint ratio of the study group was lower than that of the control group(P<0.05),and the constraint time was shorter than that of the control group(P<0.001).Before intervention,the SAS and SDS scores of the two groups were compared,with P>0.05.After 2 weeks of intervention,the SAS and SDS scores of both groups decreased,and the SAS and SDS scores of the study group were lower than those of the control group(P<0.001).Conclusions The reduced restraint protocol for ICU patients with endotracheal can reduce the risk of unplanned extubation and improve skin injury,thus relieving negative emotions.

关 键 词：脑出血 缩减约束方案 气管插管 非计划性拔管 皮肤损伤 负性情绪 

分 类 号：R743.34[医药卫生—神经病学与精神病学]