【摘要】 目的研究保证患者夜间睡眠时间的镇静策略对机械通气时间、住ICU时间、意识水平和住院不适经历等因素的影响。方法将入选50名患者随机分为两组,试验组夜间采取持续静脉泵注镇静药物以保证患者日常睡眠时间。试验组白天和对照组全天均采取按需镇静的策略。观察两组白天的意识水平,机械通气和住ICU时间,患者转出ICU时作包括紧张害怕、情绪低落、睡眠不良、疲劳感、口渴、疼痛6项内容的不适经历调查。结果两组患者机械通气天数(7.6±5.0VS7.3±2.9,P=0.125)和住ICU天数(10.0±4.8VS9.0±3.3,P=0.261)没有统计学差异。两组在机械通气第一、三天意识水平无统计学差异,第二天对照组处于焦虑或躁动时间更多(P=0.027)。不适住院经历(30%(6/20)VS31.5%(6/19)P>0.05)无统计学差异,其中严重不适(10%(2/20)VS21%(4/19)P<0.05)有统计学差异。结论保证睡眠时间的镇静策略能减少机械通气患者焦虑和躁动,减少住ICU期间的严重不适经历。更多还原

【Abstract】 Objective To investigate the effect of the sedation controlled hours of sleep on days of mechanical ventilation(MV) and in ICU,sedation level and uncomfortable experiences in MV patients.Methods 50 critically ill patients were divided into two groups.Test group patients were received continous bolus of sedation in the night to keep them sleeped until next day morning.Controlled group patients were received single bolus of sedation only when they needed in all day.To observe the sedation level in daytime,days of MV and in ICU,and a personal interview about the following ICU uncomfortable events:fear,depression,sleepless,fatigue,thirsty and pain in two groups.Results There was no statistical significance in days of MV(7.6±5.0 VS 7.3±2.9,P=0.125)and in ICU(10.0±4.8 VS 9.0±3.3,P=0.261).There was no statistical significance in sedation levels on the first and third days between two groups.On the second day more anxious and restlessness time in controlled group(P=0.027).There was no statistical significance in uncomfortable experiences(30%(6/20)VS 31.5%(6/19)P>0.05),but statistical significance in severe uncomfortable experiences(10%(2/20)VS 21%(4/19)P<0.05).Conclusion The sedation controlled hours of sleep could reduce anxious and restlessness time,and reduce severe uncomfortable experiences in ICU days.更多还原