ICU机械通气患者应用舒适化浅镇静策略早期康复指导对睡眠影响  

The Impact of Early Rehabilitation Guidance on Sleep in ICU Mechanically Ventilated Patients Using a Comfort-based Light Sedation Strategy

作　　者：林杰 LIN Jie(Department of Critical Care Medicine,the Second General Hospital of Fuzhou,Fuzhou 350007,China)

机构地区：[1]福州市第二总医院重症医学科,福州350007

出　　处：《世界睡眠医学杂志》2025年第1期71-74,共4页World Journal of Sleep Medicine

基　　金：福建省创伤骨科急救与康复临床医学研究中心(2020Y2014)。

摘　　要：目的:研究ICU机械通气患者应用舒适化浅镇静策略(eCASH策略)早期康复指导对睡眠影响。方法:选取2020年5月至2023年5月福州市第二总医院收治的ICU机械通气患者100例作为研究对象,按照随机数字表法分为对照组和观察组,每组50例。对照组采用常规康复护理,观察组采用eCASH策略下早期康复指导,回顾性分析2组治疗康复时间指标、RASS评分、用药剂量、谵妄情况以及睡眠质量评分。结果:观察组机械通气时间(4.36±0.82)d,ICU治疗时间(7.36±1.18)d,住院时间(22.14±2.60)d,短于对照组[机械通气时间(5.13±0.80)d,ICU治疗时间(8.82±1.54)d,住院时间(23.65±3.37)d],差异有统计学意义(P<0.05);观察组右美托咪定(1563.34±228.84)mg,RASS(-1.29±0.20)分,优于对照组[右美托咪定(2419.50±246.36)mg,RASS(-1.76±0.53)分],差异有统计学意义(P<0.05);观察组谵妄11例(22.00%),谵妄时间(3.62±0.69)d,低于对照组[谵妄27例(54.00%),谵妄时间(5.40±0.56)d],差异有统计学意义(P<0.05);观察组RCSQ评分(77.82±5.67^(*))分,高于对照组[RCSQ(60.53±5.24)分],差异有统计学意义(P<0.05)。结论:对ICU机械通气患者应用eCASH策略下早期康复指导,可有效缩短患者机械通气、ICU治疗的时间,减少镇静药物的剂量,预防谵妄的发生,对于患者睡眠质量改善具有重要意义。Objective:To investigate the impact of early rehabilitation guidance using the comfort-based light sedation strategy(eCASH strategy)on sleep in ICU mechanically ventilated patients.Methods:A total of 100 ICU mechanically ventilated patients admitted to Fuzhou Second General Hospital from May 2020 to May 2023 were selected as the study subjects.They were divided into a control group and an observation group using a random number table method,with 50 patients in each group.The control group received conventional rehabilitation care,while the observation group received early rehabilitation guidance under the eCASH strategy.Recovery time index,RASS score,dosage,delirium and sleep quality score of the two groups were analyzed retrospectively.Results:Observation group mechanical ventilation time(4.36±0.82)d,ICU treatment time(7.36±1.18)d,hospitalization time(22.14±2.60)d,shorter than control group[mechanical ventilation time(5.13±0.80)d,ICU treatment time(8.82±1.54)d,The length of hospitalization was(23.65±3.37)d](P<0.05).Observation group(dexmedetomidine(1563.34±228.84)mg,RASS(-1.29±0.20)points),better than control group[dexmedetomidine(2419.50±246.36)mg,RASS(-1.76±0.53)points](P<0.05).The delirium in the observation group was 11 cases(22.00%),and the delirium time(3.62±0.69)d was lower than that in the control group[27 cases(54.00%),and the delirium time(5.40±0.56)d](P<0.05).The RCSQ score of the observation group(77.82±5.67^(*))was higher than that of the control group[RCSQ(60.53±5.24)](P<0.05).Conclusion:Early rehabilitation guidance under eCASH strategy for patients with mechanical ventilation in ICU can effectively shorten the time of mechanical ventilation and ICU treatment,reduce the dose of sedative drugs,and prevent the occurrence of delirium,which is of great significance for improving the sleep quality of patients.

关 键 词：ICU机械通气 舒适化浅镇静策略 早期康复指导 时间指标 RASS评分 用药剂量 谵妄 RCSQ评分 

分 类 号：R338.63[医药卫生—人体生理学] R56[医药卫生—基础医学]