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Lancet Respir Med：腹腔手术后危重患者术后镇静与预后

2017-09-19 zhangfan MedSci原创

术后镇静危重患者ICU
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研究认为，对于腹腔手术后因器官功能障碍需进行重症监护的患者，即刻终止镇静有助于改善患者术后结果，快速回复自主呼吸,该结果支持在患者术后从手术室转移过程中即中断镇静

目前的治疗指南建议对于重症监护患者应避免过度镇静和长时间机械通气，但对于危重术后患者相应的治疗方法尚不明确。近日研究人员考察了危重术后镇静与患者预后之间的关系。

研究在法国的3个临床重症监护中心开展，成年的、腹腔手术后、预计至少需要12小时机械通气且器官衰竭评分＞1的危重患者参与研究，患者无严重急性呼吸窘迫综合征或脑损伤。患者随机接受常规监护程序或即刻终止镇静。研究的主要终点是成功拔管时间。

研究招募患者137人，其中对照组68人，干预组69人。研究发现，干预组的平均成功拔管时间显著低于对照组(8小时 vs 50小时，组间差异33.6小时[95% CI，22.4-44.9；p<0.0001)，调整后的风险比为5.2(95% CI，3.1-8.8，p<0.0001)。

研究认为，对于腹腔手术后因器官功能障碍需进行重症监护的患者，即刻终止镇静有助于改善患者术后结果，快速回复自主呼吸,该结果支持在患者术后从手术室转移过程中即中断镇静。

原始出处：


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    2018-03-04 howi

    #Lancet#

    0

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    2017-09-20 ms3994565386320060

    #Med#

    0

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    2017-09-20 小安安

    学习了.谢谢分享

    0

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    2017-09-20 159****9725

    学习了

    0

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    2017-09-19 戒馋，懒，贪

    .超厉害的说.谢谢分享

    0

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    2017-09-19 159****9725

    学习了

    0

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    2017-09-19 zt123

    你说没事慢慢南岸

    0

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    2017-09-19 小安安

    不错.谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1829206, encodeId=49f6182920664, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Mar 04 21:45:00 CST 2018, time=2018-03-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1608047, encodeId=12d4160804ebe, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Sep 20 23:45:00 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=246008, encodeId=d88d246008c4, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5a021728665, createdName=小安安, createdTime=Wed Sep 20 14:02:26 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245981, encodeId=4e7d245981da, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/24/df6c94c647a03bde8d77b50c4fb4d531.jpg, createdBy=c84e2076847, createdName=159****9725, createdTime=Wed Sep 20 11:03:17 CST 2017, time=2017-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245637, encodeId=ba7e24563ecc, content=.超厉害的说.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋，懒，贪, createdTime=Tue Sep 19 09:54:34 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245632, encodeId=3fa4245632f9, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/24/df6c94c647a03bde8d77b50c4fb4d531.jpg, createdBy=c84e2076847, createdName=159****9725, createdTime=Tue Sep 19 09:28:30 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245629, encodeId=b1af245629d8, content=你说没事慢慢南岸, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Sep 19 09:14:55 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245628, encodeId=fe8324562826, content=不错.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5a021728665, createdName=小安安, createdTime=Tue Sep 19 09:13:36 CST 2017, time=2017-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=245627, encodeId=06d624562ed2, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55a22015915, createdName=1e1ff052m13(暂无匿称), createdTime=Tue Sep 19 09:08:07 CST 2017, time=2017-09-19, status=1, ipAttribution=)]
    2017-09-19 1e1ff052m13(暂无匿称)

    学习了.谢谢分享

    0