摘要
目的评估谵妄集束化护理在ICU行机械通气患者中的应用效果。方法对2018年1月至2019年12月行机械通气患者184例进行分析,其中行危重症常护理77例为对照组,行谵妄集束化护理107例为观察组。对比2组患者APACHEⅡ评分、谵妄发生率、谵妄持续时间、镇静药物剂量、机械通气时间、ICU住院时间以及护理满意度等。结果干预前对照组和观察组APACHEⅡ评分分别为(18.25±3.11)分和(17.84±2.84)分,差异无统计学意义(P>0.05)。干预后分别为(12.57±2.31)分和(8.93±1.93)分,与干预前均显著下降且观察组显著低于对照组,差异有统计学意义(P<0.05)。对照组和观察组谵妄发生率分别为9.35%和22.08%,谵妄持续时间分别为(1.95±0.31)d和(2.57±0.48)d,观察组谵妄发生率和谵妄持续时间均显著低于对照组(P<0.05)。对照组丙泊酚、瑞芬太尼用量以及机械通气时间分别为(442.74±74.19)ml、(8.93±1.36)mg和(7.58±1.63)d;观察组上述指标分别为(371.38±69.28)ml、(7.54±1.15)mg和(6.17±1.26)d,观察组均显著低于对照组,差异有统计学意义(P<0.05)。对照组和观察组ICU住院时间分别为(12.46±2.18)d和(10.28±1.72)d,护理满意度分别为72.23%和85.05%,观察组显著低于对照组,护理满意度显著高于对照组,差异有统计学意义(P<0.05)。结论在ICU行机械通气患者中的应用谵妄集束化护理,有助于改善患者症状、降低谵妄发生率和持续时间,减少镇痛镇静药物用量,缩短机械通气时间和住院时间,提升护理满意度,值得进一步推广。
Objective To investigate the effects of delirium cluster nursing in patients undergoing mechanical ventilation in ICU.Methods A total of 184 patients who underwent mechanical ventilation in ICU of our hospital from January 2018 to December 2019 were enrolled in the study,who were divided into control group(n=77)and observation group(n=107).The patients in control group were treated by routinr nursing,however,the patients in observation group were treated by delirium cluster nursing.The ACHEⅡscore,the incidence of delirium,duration of delirium,sedatives doses,mechanical ventilation time and the length of staying in ICU as well as nursing satisfaction degree were observed and compared between the two groups.Results Before intervention there were no significant differences in APACHEⅡscores between the two groups(P>0.05).After intervention,the APACHEⅡscores in both groups were significantly decreased,moreover,which in observation group were significantly lower than those in control group(P<0.05).The incidence of delirium and the duration of delirium as well as the dosage of propofol,remifentanil and mechanical ventilation time in observation group were significantly lower than those in control group,however,the nursing satisfaction degree was significantly higher than that in control group(P<0.05).Conclusion The application of delirium cluster nursing for patients in ICU undergoing mechanical ventilation is helpful to improve the symptoms of patients,reduce the incidence and duration of delirium,reduce the dosage of analgesic and sedative drugs,shorten the duration of mechanical ventilation and hospital stay,and improve nursing satisfaction degree,therefor,it is worth further promotion in clinical practice.
作者
陈泳洁
钟萍
CHEN Yongjie;ZHONG Ping(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Chengdu Medical College,Sichuan,Chengdu 510000,China;不详)
出处
《河北医药》
CAS
2021年第24期3835-3837,共3页
Hebei Medical Journal
关键词
ICU
机械通气
谵妄
集束化护理
ICU
mechanical ventilation
delirium
cluster nursing