摘要
目的探讨《每日唤醒执行量表》在机械通气镇静肺结核患者中的临床应用效果,为规范临床护理路径提供依据。方法搜集2017年1—6月(量表实施前)浙江省中西医结合医院结核监护室收治的经临床综合诊断确诊为肺结核的127例患者,其中92例患者并发Ⅱ型呼吸衰竭,参照纳入及排除标准将入选的49例患者采用数字表法随机选取30例为对照组,在监护室期间实施常规每日唤醒护理措施;按照相同方法搜集2017年7—12月(量表实施后)我院结核监护室收治的142例经临床综合诊断确诊的肺结核患者,其中110例患者并发Ⅱ型呼吸衰竭,参照纳入及排除标准将纳入的52例患者采用数字表法随机选取30例为观察组,在实施常规每日唤醒措施的基础上,使用《每日唤醒执行量表》实施每日唤醒措施并做好记录。观察两组患者镇静剂用药时间、镇静剂总使用量、唤醒时间、机械通气时间、结核监护室入住时间,以及情绪异常等不良事件的发生率。结果两组患者均完成结核监护室全程观察。观察组镇静剂用药时间[100.50(72.50,112.75)h]、镇静剂总使用量[110.00(89.00,143.00)mg]、唤醒时间[29.50(21.00,37.75)min]、机械通气时间[119.50(99.25,138.00)h]、结核监护室入住时间[115.00(103.75,170.25)h]均优于对照组[分别为126.50(85.70,172.25)h、152.00(123.00,219.00)mg、35.50(30.75,48.00)min、145.50(123.00,227.00)h、182.00(145.25,253.75)h](Z值分别为2.795、3.408、2.717、2.994、4.081,P值分别为0.005、0.001、0.007、0.003、0.000)。唤醒期间观察组和对照组分别实施唤醒349例次和273例次,均未发生意外拔管、坠床等严重不良事件。对照组和观察组患者唤醒后出现情绪异常、血压异常、人机对抗、心率异常的发生率[分别为67.77%(185/273)和67.34%(235/349)、50.18%(137/273)和47.56%(166/349)、35.90%(98/273)和32.09%(112/349)、25.27%(69/273)和26.36%(92/349)],以及自发呼吸试验成功�
Objective To explore the clinical effect of daily awaking execution scale in patients with pulmonary tuberculosis mechanical ventilation sedation,and to provide clinical basis for standardizing clinical nursing pathway.Methods The data of 127 patients with pulmonary tuberculosis admitted to the Tubercular Intensive Care Unit (ICU) of Zhejiang Provincial Integrated Chinese and Western Medicine Hosipital from January to June 2017 (before the scale was implemented) were collected, and 92 patients with type Ⅱ respiratory failure were selected, and 30 cases were randomly selected as control group by using digital table method in 49 patients who were included in the inclusion and exclusion criteria. Routine implementation of daily wake-up measures. From the collection of 142 patients with tuberculosis admitted to the Tubercular ICU from July to December 2017 (after the scale was implemented), 110 patients with type Ⅱ respiratory failure were selected, and 30 cases were randomly selected as observation group in 52 patients who were included in the inclusion and exclusion criteria. The daily wake-up execution scale was used on the basis of routine implementation of daily wake-up measures, and the incidence of adverse events such as sedative dosage, complete sobriety time after withdrawal, duration of mechanical ventilation, duration of sedation, ICU hospitalization time, emotional abnormalities and so on were observed in the two groups.Results Both groups of patients completed full observation in the Tubercular ICU. The observation group duration of sedation (100.50 (72.50,112.75)h), the total amount of sedative (110.00 (89.00,143.00)mg), the total waking time after withdrawa (29.50 (21.00,37.75)min), duration of mechanical ventilation (119.50 (99.25,138.0)h), Tubercular ICU hospitalization time (115.00 (103.75,170.25)h) were better than the control group for each of items respectivly (126.50 (85.70,172.25)h,152.00 (123.00,219.00)mg,35.50 (30.75,48.00)min,145.50 (123.00,227.00)h,182.00 (145.25,253.75)h)(Z=2.795,3.408
作者
吴青青
宋丽君
章琳
WU Qing-qing;SONG Li-jun;ZHANG Lin(Tubercular Intensive Care Unit of Tuberculosis Center,Zhejiang Provincial Integrated Chinese and Western Medicine Hosipital (Hangzhou Red Cross Hospital),Hangzhou 310003,China)
出处
《中国防痨杂志》
CAS
CSCD
2019年第8期863-868,共6页
Chinese Journal of Antituberculosis
关键词
结核
肺
呼吸功能不全
麻醉后护理
表格和记录管理
对比研究
结果与过程评价(卫生保健)
Tuberculosis,pulmonary
Respiratory insufficiency
Postanesthesia nursing
Forms and records control
Comparative study
Outcome and process assessment (health care)
