[1]刘永瑞,何羿昕.脑出血患者术后程序化镇痛镇静护理干预效果观察[J].新乡医学院学报,2019,36(3):288-290.[doi:10.7683/xxyxyxb.2019.03.021]
　LIU Yong-rui,HE Yi-xin.Effect of procedural sedation and analgesia nursing intervention in patients with postoperative cerebral hemorrhage[J].Journal of Xinxiang Medical University,2019,36(3):288-290.[doi:10.7683/xxyxyxb.2019.03.021]
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脑出血患者术后程序化镇痛镇静护理干预效果观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年3
页码:
288-290
栏目:
护理研究
出版日期:
2019-03-05

文章信息/Info

Title:
Effect of procedural sedation and analgesia nursing intervention in patients with postoperative cerebral hemorrhage
作者:
刘永瑞; 何羿昕
（郑州人民医院护理部，河南　郑州　450001）
Author(s):
LIU Yong-rui; HE Yi-xin
(Department of Nursing,the People′s Hospital of Zhengzhou City,Zhengzhou 450001,Henan Province,China)
关键词:
脑出血; 镇静; 镇痛; 护理干预
Keywords:
cerebral hemorrhage; sedation; analgesia; nursing intervention
分类号:
R473.6
DOI:
10.7683/xxyxyxb.2019.03.021
文献标志码:
A
摘要:
目的　探讨程序化镇痛镇静护理干预在脑出血患者术后的应用效果。方法　将2016年1月至2017年12月郑州人民医院急诊重症监护病房收治的84例脑出血术后患者随机分为对照组和观察组，每组42例。对照组患者采用常规治疗及护理，观察组患者在对照组治疗及护理的基础上给予程序化镇痛镇静护理干预。护理干预后5 d采用重症监护室疼痛观察工具法(CPOT)和镇静程度量表(RASS)评估2组患者的镇痛镇静效果及颅内压（ICP）水平，并比较2组患者不良事件发生率及重症监护病房(ICU)住院时间。结果　护理干预5 d后，2组患者CPOT、RASS评分比较差异无统计学意义（t=0.524、0.739，P>0.05），观察组患者ICP水平低于对照组（t=5.214，P<0.05）。观察组患者ICU住院时间短于对照组（t=2.385，P<0.05）。对照组和观察组患者不良事件发生率分别为19.04%（8/42）和4.76%（2/42），观察组患者不良事件发生率低于对照组（χ2=58.293，P<0.05）。结论　脑出血患者术后实施程序化镇痛镇静护理干预，在保证镇痛镇静效果的同时，可降低患者ICP水平和不良事件发生率，缩短ICU住院时间。
Abstract:
Objective　To study the application value of procedural sedation and analgesia nursing intervention in patients with postoperative cerebral hemorrhage.Methods　Eighty-four patients with postoperative cerebral hemorrhage in the Emergency Intensive Care Unit of the People′s Hospital of Zhengzhou City from January 2016 to December 2017 were selected and randomly divided into control group and observation group,with 42 cases in each group.The patients in the control group was treated with routine treatment and nursing.Based on the treatment of the control group,the patients in the observation group was given procedural sedation and analgesia nursing intervention.At five days after nursing intervention,the sedation and analgesia effect of the two groups was evaluated by CPOT and richmond agitation-sedation scale (RASS) and the intracranial pressure(ICP) was recorded.The incidence of adverse events and length of stay in intensive care unit（ICU) were compared between the two groups.Results　At five days after nursing intervention,there was no significant difference in the CPOT and RASS score between the two groups (P>0.05),but the ICP in the observation group was lower than that in the control group （t=5.214，P<0.05）.The length of stay in ICU of the observation group was shorter than that of the control group （t=2.385，P<0.05）.The incidence of adverse events in the control group and the observation group was 19.04%（8/42）and 4.76%（2/42）,respectively.The incidence of adverse events in the observation group was lower than that in the control group（χ2=58.293，P<0.05）.Conclusion　The application of programmed analgesic and sedative nursing intervention after intracerebral hemorrhage can not only ensure the sedative and analgesic effect,but also reduce the ICP level and the incidence of adverse events,and shorten the length of stay in the ICU.

参考文献/References:

［1］　吴卫红.中国脑性瘫痪康复指南(2015):第九部分［J］.中国康复医学杂志,2016,31(3):371-373.
［2］　赵文静,贾珍珍.重症监护病房病人镇静的护理进展［J］.护理研究,2013,27(14):1294-1296.
［3］　林丽美,蒋云琴.颅脑损伤患者躁动的原因分析与护理体会［J］.中国实用医药,2012,7(28):219-220.
［4］　陈维生.颅脑损伤患者躁动的原因与处理［J］.中外医学研究,2011,9(22):151-153.
［5］　胡艳芳.重症颅脑损伤患者行动态颅内压监测调查分析［J］.中国实用神经疾病杂志,2015,18(11):40-42.
［6］　安友仲.重症患者的镇痛镇静治疗：理想与现实的渐近［J］.医学与哲学,2013,34(24):23-26.
［7］　牟丹,向镜芬,邓艳琼，等.重度颅脑损伤术后患者实施程序化镇静镇痛的护理研究［J］.护理学杂志,2015,30(8):35-39.
［8］　李利.ICU患者程序化镇痛镇静治疗及护理干预［J］.齐鲁护理杂志,2014,20(19):93-94.
［9］　徐珏华,徐彩娟.56例镇静患者每日行唤醒疗法的护理［J］.护理与康复,2009,8(8):692-693.
［10］　陈彩.重症颅脑损伤患者程序化镇痛镇静治疗与护理干预方法研究［J］.基层医学论坛,2016,20(16):2288-2289.
［11］　刘海燕,蒲黎明,朱新洪.程序化镇静镇痛在重度颅脑损伤术后的应用及护理干预［J］.当代护士,2017,25(3):73-74.
［12］　李利.重症颅脑损伤患者程序化镇痛镇静治疗与护理干预方法［J］.疾病监测与控制,2015,9(10):753-754.
［13］　ROBINSON B R，MUENER E W，HENSON K，et al.An analgesia delirium sedation protoc01 for critically ill trauma patients reduces ventilator days and hospital length of stay［J］.J Trauma,2008,65(3):517-526.

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更新日期/Last Update: 2019-03-05