[1]宋诗荻.早期目标导向镇静护理在RICU机械通气患者中的应用[J].医学信息,2023,36(16):158-161.[doi:10.3969/j.issn.1006-1959.2023.16.032]
　SONG Shi-di.Application of Early Goal-directed Sedation Nursing in RICU Patients with Mechanical Ventilation[J].Journal of Medical Information,2023,36(16):158-161.[doi:10.3969/j.issn.1006-1959.2023.16.032]
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早期目标导向镇静护理在RICU机械通气患者中的应用()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年16期
页码:
158-161
栏目:
护理研究
出版日期:
2023-08-15

文章信息/Info

Title:
Application of Early Goal-directed Sedation Nursing in RICU Patients with Mechanical Ventilation
文章编号:
1006-1959（2023）16-0158-04
作者:
宋诗荻
（天津市胸科医院RICU，天津 300000）
Author(s):
SONG Shi-di
(RICU of Tianjin Chest Hospital,Tianjin 300000,China)
关键词:
目标导向镇静护理; RICU; 机械通气
Keywords:
Goal-oriented sedation nursing; RICU; Mechanical ventilation
分类号:
R473.6
DOI:
10.3969/j.issn.1006-1959.2023.16.032
文献标志码:
A
摘要:
目的 观察早期目标导向镇静护理在RICU机械通气患者中的应用效果。方法 选取2021年5月-2022年6月在我院RICU接受机械通气治疗的60例患者为研究对象，采用随机数字表法分为对照组和观察组，各30例。对照组采用常规护理干预，观察组在对照组基础上实施早期目标导向镇静护理干预，比较两组Glasgow昏迷评分、RASS镇静评分、认知功能评分、机械通气时间、RICU入住时间、谵妄发生率、1次性拔管成功率。结果 两组拔管后Glasgow昏迷评分均高于插管时，且观察组高于对照组（P＜0.05）；两组拔管后镇静评分高于插管时，且观察组高于对照组（P＜0.05）；拔管时观察组认知功能各维度（时间定向力、即刻记忆、物体识别、地点定向）评分均高于对照组（P＜0.05）；观察组机械通气时间、RICU入住时间短于对照组（P＜0.05）；观察组谵妄发生率为6.67%，低于对照组的20.00%（P＜0.05）；观察组1次性拔管成功率为93.33%，高于对照组的80.00%（P＜0.05）。结论 早期目标导向镇静护理在RICU机械通气患者中的应用效果确切，可提高拔管时Glasgow昏迷、RASS镇静评分，缩短机械通气和RICU入住时间，提高1次性拔管成功率，提升患者拔管后认知功能，预防谵妄的发生。
Abstract:
Objective To observe the application effect of early goal-oriented sedation nursing in RICU patients with mechanical ventilation.Methods Sixty patients who received mechanical ventilation in RICU of our hospital from May 2021 to June 2022 were selected as the research objects. They were divided into control group and observation group by random number table method, with 30 patients in each group. The control group was treated with routine nursing intervention, and the observation group was treated with early goal-directed sedation nursing intervention on the basis of the control group. The Glasgow coma score, RASS sedation score, cognitive function score, mechanical ventilation time, RICU occupancy time, delirium incidence, and success rate of one-time extubation were compared between the two groups.Results The Glasgow coma score of the two groups after extubation was higher than that at intubation, and that in the observation group was higher than that in the control group (P<0.05). The sedation score of the two groups after extubation was higher than that at intubation, and that in the observation group was higher than that in the control group (P<0.05). At the time of extubation, the scores of each dimension of cognitive function (time orientation, immediate memory, object recognition, location orientation) in the observation group were higher than those in the control group (P<0.05). The mechanical ventilation time and RICU stay time in the observation group were shorter than those in the control group (P<0.05). The incidence of delirium in the observation group was 6.67%, which was lower than 20.00% in the control group (P<0.05). The success rate of one-time extubation in the observation group was 93.33%, which was higher than 80.00% in the control group (P<0.05).Conclusion Early goal-directed sedation nursing is effective in patients with mechanical ventilation in RICU, which can improve Glasgow coma and RASS sedation score during extubation, shorten the time of mechanical ventilation and RICU stay, improve the success rate of one-time extubation, improve the cognitive function of patients after extubation, and prevent the occurrence of delirium.

参考文献/References:

[1]杨杰,康焰.镇静对机械通气患者呼吸功能的影响[J].中华危重病急救医学,2017,29(9):857-860.[2]徐建宁,汪国建,冯洁惠.早期目标导向型镇静用于RICU机械通气患者的效果评价[J].护理学杂志,2016,31(10):25-28.[3]郭海凌,马玉芬,孙丹丹,等.RICU护士评估 Richmond躁动鄄镇静量表准确性现状调查及影响因素分析[J].中华现代护理杂志,2018,24(28):3377-3381.[4]Aydogan S,Kaya N.The Assessment of the Risk of Unplanned Extubation in an Adult Intensive Care Unit[J].Dimens Crit Care Nurs,2017,36(1):14-21.[5]席与斌,李佳,张俊,等.机械通气重症患者行持续浅镇静目标导向调控方案的效果研究[J].川北医学院学报,2019,34(5):570-573.[6]姜昆,纪丽娜,王晶美,等.持续性浅镇静目标导向调控策略对RICU机械通气患者呼吸动力学的影响研究[J].黑龙江医学,2019,43(5):444-445.[7]徐建宁,汪国建,冯洁惠.早期目标导向型镇静用于RICU机械通气患者的效果评价[J].护理学杂志,2016,31(10):25-28.[8]黄艳.早期目标导向性镇静在RICU机械通气患者中的应用[J].护理实践与研究,2018,15(13):50-52.[9]王颖,朱浩,陈金亮,等.改良早期目标导向镇静策略对严重创伤患者预后的影响[J].临床急诊杂志,2020,21(3):192-197.[10]贵春梅,黄绍华,陈智峰,等.机械通气患者早期目标导向型镇静镇痛药物配伍优化研究[J].医学理论与实践,2018,31(14):2126-2128.[11]Hannam JA,Mitchell SJ,Cumin D,et al.Haemodynamic profiles of etomidate vs propofol for induction of anaesthesia: a ran-domised controlled trial in patients undergoing cardiac surgery[J].Br J Anaesth,2019,122(2):198-205.[12]赵先美,叶曼,李知音,等.eCASH理念运用于RICU机械通气患者镇静镇痛管理的效果评价[J].中国护理管理,2018,18(4):533-537.[13]贺晓元,刘婷.早期活动对RICU机械通气患者谵妄发生的影响[J].护士进修杂志,2017,32(16):1500-1502.[14]Mistr Aletti G,Umbrello M,Salini S,et al.Enteral versus intravenous approach for the sedation of critically ill patients: a ran- domized and controlled trial[J].Crit Care,2019,23(1):3.[15]李丽媚.eCASH理念在RICU机械通气患者镇静镇痛管理中的应用现状[J].天津护理,2021,29(3):358-361.[16]欧寿六,何茹,杨元立,等.镇静唤醒结合早期活动指导在RICU机械通气患者中的效果及对机体免疫功能的影响[J].护理实践与研究,2020,17(9):46-48.[17]莫景.eCASH理念在RICU机械通气病人早期活动中的应用[J].全科护理,2020,18(7):848-851.[18]刘文娟,邢金燕,接亚琦.山东省RICU医护人员对IC谵妄认知态度的调查分析[J].中国实用护理杂志,2017,33(2):130-134.[19]申文娟,易兴科,张凯,等.早期目标导向镇静用于慢性阻塞性肺疾病急性加重机械通气患者的临床观察[J].临床肺科杂志,2020,4(2):121-123.[20]赵焕杰,彭燕.EGDS策略对RICU机械通气患者镇静效果及认知功能的影响[J].国际护理学杂志,2021,11(8):302-304.

更新日期/Last Update: 1900-01-01