摘要
目的探讨早期集束化康复护理方案对行机械通气患者谵妄发生情况的影响。方法回顾性分析2021年4月至2022年1月在南京脑科医院重症监护室(ICU)行机械通气的92例患者的一般资料,根据护理模式的不同分为观察组(46例)和对照组(46例)。对照组采用传统护理模式,观察组在对照组方法的基础上结合早期集束化康复护理。比较2组的谵妄发生率、谵妄持续时间及机械通气持续时间,并比较2组的功能独立性评定量表(FIM)评分、血清5-羟色胺(5-HT)、γ-氨基丁酸(GABA)、多巴胺(DA)水平及不良事件发生率。结果干预2周和1个月后,观察组的5-HT、GABA水平和FIM评分均高于同期对照组,DA水平均低于同期对照组,观察组在干预后的不良事件发生率和谵妄发生率均较对照组更低,谵妄持续时间及机械通气持续时间均较对照组更短(P均<0.05)。结论集束化护理能够有效降低谵妄的发生率,缩短患者的谵妄持续时间和机械通气时间,降低不良事件发生率,加快患者康复。
Objective To explore the effect of early cluster rehabilitation nursing program on the occurrence of delirium in patients with mechanical ventilation.Methods A retrospective analysis was conducted on the general data of 92 patients who underwent mechanical ventilation in the Intensive Care Unit(ICU)of Nanjing Brain Hospital from April 2021 to January 2022.They were divided into an observation group(46 cases)and a control group(46 cases)based on different nursing modes.The control group adopted the traditional nursing mode,while the observation group received early cluster rehabilitation nursing on the basis of the control groups method.Incidence of delirium,duration of delirium,duration of mechanical ventilation,Functional Independence Measure(FIM)scores,serum 5-hydroxytryptamine(5-HT),γ-aminobutyric acid(GABA)and dopamine(DA)levels and incidence of adverse events were compared between the two groups.Results After 2 weeks and 1 month of intervention,the levels of 5-HT、GABA and the FIM scores of the observation group were higher than those in the control group during the same period,while the levels of DA in the observation group were lower than those in the control group during the same period(P<0.05).After intervention,the incidence of adverse events and delirium in the observation group were lower than those in the control group,and the duration of delirium and mechanical ventilation in the observation group were shorter than those in the control group(all P<0.05).Conclusion Cluster nursing can effectively reduce the incidence of delirium,shorten the duration of delirium and the mechanical ventilation time of patients,reduce the incidence of adverse events,and promote the recovery process of patients.
作者
韩俊逸
李文玲
莫小娟
HAN Junyi;LI Wenling;MO Xiaojuan(Nanjing Brain Hospital,Nanjing,Jiangsu,210000,China)
出处
《中西医结合护理（中英文）》
2023年第9期25-28,共4页
Journal of Clinical Nursing in Practice
关键词
机械通气
集束化康复护理
谵妄
不良事件
mechanical ventilation
cluster rehabilitation nursing
delirium
adverse event
