摘要
目的分析依据人体正常作息调整镇静药物使用对重症加强护理病房(ICU)机械通气患者的临床应用效果,为其合理用药提供参考。方法选取2016年1月—2017年1月在金华市人民医院诊断且符合纳入标准的60例ICU机械通气患者为研究对象,采用随机数字表法将其分为观察组和对照组,每组各30例,对照组患者采用常规干预模式进行治疗,观察组患者依据人体正常作息调整镇静药物的使用,运用Ricker镇静-躁动评分量表(SAS)及重症监护疼痛评分量表(CPOT)对机械通气患者的镇静镇痛深度进行控制,比较2组患者谵妄等不良反应发生率及临床指标(通气时间、ICU治疗时间、收缩压、舒张压、心率、动脉血氧饱和度)间的差异。结果观察组患者的VAP发生率显著低于对照组(P<0.05),观察组患者的通气时间、ICU治疗时间、收缩压、舒张压、心率以及芬太尼、丙泊酚和右美托咪定用量均明显低于对照组(均P<0.05),其动脉血氧饱和度(Sa O2)水平明显高于对照组(P<0.05)。结论依据人体正常作息调整镇静药物的使用可以显著降低患者不良反应发生率,改善患者临床相关指标水平,对ICU机械通气患者的治疗具有较高的临床应用价值。
Objective To analyze the clinical application of sedative drugs in Intensive Care Unit(ICU) patients with mechanical ventilation based on normal rest,to provide a referencefor its clinical care.Methods Sixty patients with ICU mechanical ventilation who were diagnosed and met in our hospital in January 2016 and January 2017 were divided into observation group(30 cases) and control group(30 cases) according to the random number table method.The patients in the control group were treated with routine intervention mode.The patients in the observation group adjusted the use of sedative drugs according to the normal rest.The sedative and analgesic depth of patients with mechanical ventilation was controlled by the Ricker Sedation-Agitation Scale(SAS) and the Critical-care Pain Observation Tool(CPOT).Comparison of the incidence of adverse events(ventilation time,ICU treatment time,systolic blood pressure,diastolic blood pressure,heart rate,arterial oxygen saturation) and the differences of the clinical indicators between the subgroups.Results The incidence of VAP in the observation group was significantly lower than that in the control group(P < 0.05).The level of arterial oxygen saturation(Sa O2) of observation group were significantly higher than those of control group(all P < 0.05).The ventilation time,ICU treatment time,systolic blood pressure,diastolic blood pressure,heart rate and the dosage of fentanyl,propofol and dexmedetomidine in observation group were significantly lower than those of control group(P < 0.05).Conclusion According to the normal rest to adjust the use of sedative drugs can significantly reduce the incidence of adverse reactions and improve the level of clinical indicators of patients,which has high clinical value in the treatment of ICU patients with mechanical ventilation.
作者
郭莉娟
潘利飞
GUO Li-juan;PAN Li-fei(Department of Intensive Care Unit,Jinhua People's Hospital,Jinhua ,Zhejiang 321000,China)
出处
《中华全科医学》
2019年第2期317-320,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2014KYB294)
