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  • 重症监护室机械通气镇静策略研究进展
    来源:http://www.sdyhrs.com 浏览: 发布日期:2018-01-31
    有创机械通气的重症患者常会经历生理和心理上的各种不良体验,重症监护室(ICU)内常规的做法是对患者采取镇静措施,这样既能缓解患者各种不适,保证机械通气等治疗的顺利进行,还能起到器官保护作用。然而镇静治疗在发挥其积极作用的同时也产生了众多不良后果,甚至出现弊大于利,因此ICU内如何选择合适的镇静策略始终是亟待解决的难题。
    Some patients with severe mechanical ventilation often experience a variety of adverse physical and psychological experience, ICU (ICU) approach is to take routine sedation measures on patients, so as to alleviate patient discomfort, ensure mechanical ventilation treatment smoothly, but also play a role in organ protection. However, sedation plays a positive role in the process, and at the same time, it also produces many adverse consequences, and even more harm than good. Therefore, how to choose the appropriate sedation strategy in ICU is always a difficult problem to solve.
    对ICU重症患者实施镇静有其积极的一面,但在实际操作过程中存在着诸多顾虑,因而众多ICU并未真正实施镇静措施。2006年一项针对国内31家三级甲等医院的多中心调查研究结果显示,37.4%的患者未给予任何镇静治疗,仅14.7%给予以镇痛为基础的系统镇静。临床医师对ICU患者镇静重要性的认同率高、但实施少的主要原因在于镇静治疗对呼吸、循环等系统有负面效应,监测设备匮乏,频繁监测所需人员不足,并且目前仍缺乏有效的镇静评估手段,容易出现镇静不足或过度镇静,从而导致一系列新问题的出现。
    There is a positive side to sedation in patients with severe ICU, but there are many concerns in the actual operation process, so many ICU did not really implement sedation measures. In 2006, a multi center survey of 31 three grade A hospitals in China showed that 37.4% of the patients did not give any sedative treatment, and only 14.7% received analgesia based systematic sedation. The clinician identity of ICU sedation rate is high, but the importance of the implementation of the main reason lies in the less sedative treatment has a negative effect on the respiratory and circulatory system, lack of monitoring equipment, frequent monitoring of required personnel is insufficient, and there is still a lack of effective sedation assessment method, prone to inadequate sedation or excessive sedation, resulting in a a series of new problems.
    ICU的应用范围日益扩大,而且在不断地进步和普及。如何更合理、更有效地利用空间、人力、资金,来配置和管理维护其设备,已成为十分重要的问题。
    The scope of the application of ICU is increasing, and it is constantly improving and popularizing. How to make use of space, manpower and funds more rationally and effectively to configure and manage and maintain its equipment has become a very important problem.
    由于ICU病房的病人,与普通病房病人的状况不同,因此,其病房格局设计、环境要求、病床功能、周边设备等,都与普通病房不同,并且,不同专科的ICU,要求配备的设备也各不相同。病房的设计与设备配置,应以满足需要、便于抢救、减少污染为原则。
    Because the patients in the ICU ward are different from the patients in the general ward, their ward pattern design, environmental requirements, sickbed function and peripherals are all different from those in the general ward, and ICU of different specialties requires different equipment. The design and equipment configuration of the ward should be based on the principle of meeting the needs, saving the rescue and reducing the pollution.
    ICU镇静治疗发展至今,以"患者为中心"的个体化治疗是目前镇静治疗的医疗指导方针,通过合理的镇静措施既让患者感到舒适、实现器官的保护作用又能避免过浅或过度镇静导致的不良后果,实现镇静的大程度获益。镇静过程需要严密的监测和评估,而目前医疗资源仍匮乏,要真正实现全面的个体化镇静治疗仍需要广大医务人员的共同努力。
    ICU sedation therapy development so far, "individualized treatment of patients as the center" is the sedative treatment medical guidelines, through reasonable sedation measures not only make patients feel comfortable, to achieve the protective effect of organs and can avoid the adverse consequences caused by shallow or excessive sedation, sedation to achieve maximum benefit. The sedation process needs strict monitoring and evaluation, but at present, medical resources are still scarce. To truly achieve a comprehensive individualized sedation treatment, the majority of medical staff still need to work together.
    本文由重症监护室装修友情奉献,更多有关的知识请点击:http://www.sdyhrs.com我们将用先进的技术,真诚的态度,为您提供为全面的服务。我们将会陆续向大家奉献,敬请期待。
    This article is based on ICU decoration, friendship, dedication, and more related knowledge. Please click: http://www.sdyhrs.com, we will provide you with the most advanced technology and the most sincere attitude to provide you with the most comprehensive service. We will continue to contribute to you and look forward to it.

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