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目的观察每日唤醒次数对呼吸机相关性肺炎发生率的影响。方法将120例全部实行有创机械通气治疗的重症监护病房的病人,分为5组;各组在常规综合治疗同时,对照组加用咪达唑仑镇静,镇静深度为Ramsay分级3~4级,实施每日早晚1~4次的唤醒计划,每次持续2小时。观察四组机械通气时间、ICU停留时间和依据预先自制定的研究方案确认的VAP发生率。结果对照组在机械通气时间、ICU停留时间、VAP发生率为:138.1±65.4;183.8±73.7;22.41(13/66)。治疗组1在机械通气时间、ICU停留时间、VAP发生率为:104.5±65.0;159.5±80.7;6.50(5/62)。治疗组2在机械通气时间、ICU停留时间、VAP发生率为:89.2±52.3;131.2±79.5;2.68(3/58)。治疗组3在机械通气时间、ICU停留时间、VAP发生率为:99±61.2;156.8±90.3;11.94(8/67)。治疗组4在机械通气时间、ICU停留时间、VAP发生率为:149±63.8;193.2±83.1;26.79(15/56)。结论每日唤2次,可明显缩短重症病人机械通气时间、ICU停留时间和VAP发生率。
Objective To observe the effect of daily awakening on the incidence of ventilator-associated pneumonia. Methods A total of 120 patients with intensive care unit who underwent invasive mechanical ventilation were divided into five groups. At the same time, the patients in the control group were treated with midazolam sedation and the sedation depth was Ramsay grade 3 to 4 , The implementation of daily wakeup plan 1 to 4 times a day, each lasting 2 hours. Four groups of mechanical ventilation time, ICU stay time and the incidence of VAP confirmed according to the pre-established research program were observed. Results In the control group, the incidence of VAP during mechanical ventilation, ICU stay and VAP were: 138.1 ± 65.4; 183.8 ± 73.7; 22.41 (13/66). Treatment group 1 in the mechanical ventilation time, ICU residence time, VAP incidence was: 104.5 ± 65.0; 159.5 ± 80.7; 6.50 (5/62). Treatment group 2 in the mechanical ventilation time, ICU dwell time, the incidence of VAP: 89.2 ± 52.3; 131.2 ± 79.5; 2.68 (3/58). Treatment group 3 in the mechanical ventilation time, ICU residence time, VAP incidence was: 99 ± 61.2; 156.8 ± 90.3; 11.94 (8/67). Treatment group 4 in the mechanical ventilation time, ICU residence time, VAP incidence: 149 ± 63.8; 193.2 ± 83.1; 26.79 (15/56). Conclusion Call 2 times a day, can significantly shorten the duration of mechanical ventilation in patients with severe ICU stay and VAP incidence.