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中华重症医学电子杂志 ›› 2023, Vol. 09 ›› Issue (02) : 135 -142. doi: 10.3877/cma.j.issn.2096-1537.2023.02.003

所属专题: 重症医学 总编推荐 中国重症基层诊疗流程

诊疗流程

成人重症患者镇痛镇静诊疗流程
刘帅, 徐珊珊, 王淑雅, 侯梦雪, 苗明月, 田莹, 张琳琳(), 周建新()   
  1. 100070 北京,首都医科大学附属北京天坛医院重症医学科
    100038 北京,首都医科大学附属北京世纪坛医院重症医学科
  • 收稿日期:2023-03-08 出版日期:2023-05-28
  • 通信作者: 张琳琳, 周建新
  • 基金资助:
    北京市卫生健康科技成果和适宜技术推广项目(BHTPP2022026); 首都临床诊疗技术研究及转化应用项目(Z201100005520050)

Protocolized diagnosis and treatment for pain and agitation in critically ill adults

Shuai Liu, Shanshan Xu, Shuya Wang, Mengxue Hou, Mingyue Miao, Ying Tian, Linlin Zhang(), Jianxin Zhou()   

  1. Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
    Department of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Received:2023-03-08 Published:2023-05-28
  • Corresponding author: Linlin Zhang, Jianxin Zhou
引用本文:

刘帅, 徐珊珊, 王淑雅, 侯梦雪, 苗明月, 田莹, 张琳琳, 周建新. 成人重症患者镇痛镇静诊疗流程[J/OL]. 中华重症医学电子杂志, 2023, 09(02): 135-142.

Shuai Liu, Shanshan Xu, Shuya Wang, Mengxue Hou, Mingyue Miao, Ying Tian, Linlin Zhang, Jianxin Zhou. Protocolized diagnosis and treatment for pain and agitation in critically ill adults[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2023, 09(02): 135-142.

镇痛镇静是重症患者治疗中重要的组成部分之一。近年来,随着研究的不断深入,形成了以镇痛优先、轻度镇静控制躁动、筛查并防治谵妄、早期活动和改善睡眠为主要特征的综合策略,但目前尚缺乏简洁易操作的流程图。基于此,笔者制定了重症患者镇痛镇静诊疗流程,以期为临床实践提供一个实操性强的工具。

Analgesia and sedation are crucial for critically ill patients. In recent years, a comprehensive strategy featuring prioritized analgesia, light sedation, delirium screening and prevention, early mobility and sleep improvement has been formed. However, a concise and easy-to-operate flow chart still needs to be improved. We have developed a protocolized process for pain and agitation management for critically ill patients to provide a hands-on tool in clinical practice.

图1 镇痛镇静评估流程注:GCS为格拉斯哥昏迷量表;VAS为视觉模拟评分法;NRS为数字评价量表;CPOT为重症监护室疼痛观察工具法;BPS为行为疼痛量表;RASS为Richmond躁动-镇静评分;SAS为Riker镇静躁动评分;CAM-ICU为ICU意识模糊评估法;ICDSC为重症监护谵妄筛查表;FOUR为全面无反应性量表评分;MRC为英国医学研究理事会版徒手肌力评估量表
图2 镇痛镇静干预流程
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