目标导向镇痛镇静策略在神经外科重症患者中的临床应用与预后分析OA
Clinical application and prognosis analysis of goal-directed analgesia and sedation strategies in neurosurgical intensive care patients
目的 探讨神经外科重症患者使用目标导向镇痛镇静策略的临床效果,并探讨该方法对患者预后的影响.方法 选取2024年1月至2025年4月遵义医科大学第三附属医院86例神经外科重症患者作为研究对象,按照随机数字表法分为对照组和研究组,每组各43例.对照组接受常规镇痛镇静,研究组接受目标导向镇痛镇静策略.比较两组临床指标、生命体征、镇痛、镇静效果、脑功能、格拉斯哥昏迷评分量表(GCS)评分及并发症发生情况.结果 研究组机械通气时间、ICU入住时间均短于对照组,差异有统计学意义(P＜0.05);治疗后,研究组心率(HR)、呼吸频率(RR)低于对照组,氧合指数(PaO2/FiO2)水平高于对照组,差异有统计学意义(P＜0.05);治疗后,研究组视觉模拟评分法(VAS)评分、Ramsay镇静评分均低于对照组,差异有统计学意义(P＜0.05);治疗后,研究组谵妄评估量表(DRS)评分低于对照组、GCS评分高于对照组,差异有统计学意义(P＜0.05);研究组并发症总发生率低于对照组,差异有统计学意义(P＜0.05).结论 在神经外科重症治疗中,实施目标导向的镇痛镇静策略提升患者的镇痛和镇静效果,并有效降低并发症发生率,展现了其突出的临床价值,有助于改善患者预后.
Objective To explore the clinical effect of goal-directed analgesia and sedation strategy in neurosurgical critical patients,and to explore the effect of this method on the prognosis of patients.Methods A total of 86 neurosurgical intensive care patients admitted to the Third Affiliated Hospital of Zunyi Medical University from January 2024 to April 2025 were selected as the study subjects.They were divided into control group and study group using random number table method,with 43 patients in each group.The control group received conventional analgesia and sedation,while the study group received goal-directed analgesia and sedation strategy.Clinical indicators,vital signs,analgesic and sedative effects,cerebral function,Glasgow coma scale(GCS)scores,and the incidence of complications were compared between the two groups.Results The mechanical ventilation time and ICU stay time of the study group were shorter than those of the control group,and the differences were statistically significant(P＜0.05).After treatment,the heart rate(HR)and respiratory rate(RR)in the study group were lower than those in the control group,and the oxygenation index(PaO2/FiO2)level was higher than that in the control group,and the differences were statistically significant(P＜0.05).After treatment,the visual ana-logue scale(VAS)and Ramsay sedation score of the study group were lower than those of the control group,and the differences were statistically significant(P＜0.05).After treatment,the delirium rating scale(DRS)score of the study group was lower than that of the control group,and the GCS score was higher than that of the control group,and the differences were statistically significant(P＜0.05).The total incidence of complications in the study group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion In the treatment of neurosurgical inten-sive care unit,the implementation of goal-directed analgesia and sedation strategy can improve the analgesic and sedative effects of patients,effectively reduce the incidence of complications,and show its outstanding clinical value and help to improve the prognosis of patients.
郑凯文;李建萍
遵义医科大学第三附属医院(遵义市第一人民医院)神经重症医学科,贵州遵义 563000遵义医科大学第三附属医院(遵义市第一人民医院)神经重症医学科,贵州遵义 563000
医药卫生
目标导向镇痛镇静策略神经外科重症临床应用预后
Goal-directed analgesia and sedation strategyNeurosurgical intensive careClinical applicationPrognosis
《中国当代医药》 2026 (6)
43-47,5
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