ICU日记对ICU机械通气患者创伤后应激障碍的干预效果

目的 探讨ICU日记在预防ICU机械通气患者创伤后应激障碍（post-traumatic stress disorder,PTSD中的效果。方法 采用随机数字表法将152例ICU机械通气患者分为观察组和对照组，各76例。观察组在转出ICU 1个月后应用ICU日记进行干预，对照组仅进行常规护理。观察2组患者在转出ICU 3个月后的ICU相关记忆、PTSD发生率、焦虑抑郁情况、睡眠质量以及生活质量。结果 转出ICU 3个月后，观察组ICU事实记忆数量多于对照组（Z=-3.310,P=0.010）,PTSD发生率、匹兹堡睡眠质量调查问卷总分均明显低于对照组（χ2=3.967,P=0.046;t=-2.612,P<0.001）；观察组生活质量总分明显高于对照组（t=2.181,P=0.013）。结论 ICU日记法可部分改善ICU机械通气患者ICU相关记忆，并降低PTSD发生率，提高患者睡眠质量和生活质量。

Intervention effects of ICU diary on preventing post-traumatic stress disorder for patients with mechanical ventilation in ICU

Objective To analyze the effect of ICU diary on preventing post-traumatic stress disorder(PTSD)for patients with mechanical ventilation in ICU.Methods A total of 152 patients with mechanical ventilation in ICU were randomly divided into an observation group and a control group,each of 76.The observation group received intervention based on the ICU diary 1 month after being transferred from ICU,while the control group received routine nursing only.The ICU related memory,the incidence of PTSD,anxiety and depression,sleep quality and life quality were observed and compared 3 months after leaving ICU.Results After 3 months out of ICU,the number of the factual memories in ICU of the observation group was more than that of the control group(t=-3.310,P=0.010),the incidence of PTSD,and scores of pittsburgh sleep quality index of the observation group were significantly lower than that of the control group(χ²=3.967,P=0.046;t=-2.612,P<0.001).However,the total score of SF-36 of the former was significantly higher than the latter group(t=2.181,P=0.013).Conclusion ICU diary can partially improve ICU related memory,reduce the incidence of PTSD,and better the sleep and life quality of patients with mechanical ventilation in ICU.