摘要
目的:分析基于eCASH理念的最小化镇静策略联合早期目标导向活动在ICU机械通气患者中的应用效果。方法:选择2019年1月—12月期间入院的56例ICU机械通气患者,随机分为干预组与对照组。给予对照组患者镇痛、镇静及ICU常规肢体活动护理,干预组患者实施基于eCASH理念的最小化镇静策略联合早期目标导向活动护理方案。比较两组患者镇静剂用量、舒适度、谵妄发生率、肌力、机械通气时间、ICU住院天数和一次性成功拔管率。结果:干预组患者镇静剂用量、机械通气时间、ICU住院天数少于对照组(P<0.05),舒适度、肌力、一次性成功拔管率高于对照组(P<0.05),谵妄发生率低于对照组(P<0.05)。结论:对ICU机械通气患者实施基于eCASH理念的最小化镇静策略联合早期目标导向活动,可减少镇静剂使用量,提高患者舒适度、一次性成功拔管率,降低患者谵妄发生率,缩短机械通气时间,减少ICU住院天数,促进疾病康复。
Objective:To analyze the implementation of the minimal sedation strategy combined with early goaloriented mobilization guided by the principle of eCASH in patients undergoing mechanical ventilation in the Intensive Care Unit(ICU).Methods:Patients who were admitted to the ICU from January to December in 2019 in the study hospital and underwent mechanical ventilation were eligible for participating in the current study.A total of 56 patients were divided into two groups(one to one ratio,n=28 patients in each group):the intervention group and the control group.Patients in both groups were given analgesics and sedatives along with routine physical activities for ICU patients.Patients in the intervention group were treated with the minimal sedation strategy combined with an early goal-oriented mobilization nursing program following the principle of eCASH.The dosage of sedatives,comfort level among patients,incidence of delirium,muscle strength,duration of mechanical ventilation,length of ICU stay and the one-time successful extubation rate were compared between the two groups.Results:The dosage of sedatives,duration of mechanical ventilation and length of ICU stay among patients in the intervention group were significantly and statistically less than those in the control group(P<0.05).The comfort level in patients in the intervention group was significantly better than that in patients in the control group(P<0.05).The incidence of delirium in the intervention group was significantly lower than that in the control group(P<0.05).The onetime successful extubation rate and muscle strength in the intervention group were also significantly better than those in the control group(P<0.05).Conclusion:For patients undergoing mechanical ventilation in the ICU,the implementation of the minimal sedation strategy combined with early goal-oriented mobilization following the principle of eCASH can reduce the dosage of sedatives and occurrence of delirium,shorten the length of mechanical ventilation and ICU stay,improve patients'comfort level,the success rate of one-time extubation,and promote patient recovery.
作者
卞红
刘海英
俞萍
孙芹
朱晔
BIAN Hong;LIU Haiying;YU Ping;SUN Qin;ZHU Ye(Department of Intensive Care Unit,Wuxi Second Hospital Affiliated to Nanjing Medical University,Wuxi,Jiangsu province,214002,China)
出处
《中国护理管理》
CSCD
2022年第1期124-128,共5页
Chinese Nursing Management
基金
南京医科大学科技发展项目(NMUB2018238)
无锡市“双百”中青年医疗卫生拔尖人才培养计划项目(HB2020034)。
关键词
eCASH理念
镇静策略
早期目标导向活动
机械通气
eCASH principle
sedation strategy
early goal-oriented mobilization
mechanical ventilation
