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会计学
ICU病人睡眠紊乱
主要内容
正常睡眠生理
ICU睡眠的评估
ICU病人睡眠紊乱
与ICU睡眠紊乱有关的因素
睡眠紊乱的不良后果
ICU病人睡眠保护策略
正常睡眠生理
睡眠是一种持续性的、可逆的、并伴随着反应能力减弱和主动行为消失的行为状态。
睡眠状态可以迅速转变为觉醒状态,这是睡眠不同于昏迷、麻醉和冬眠等丧失感觉和行为能力状态的一个显著标志。
睡眠分为慢波睡眠和异相睡眠两个时相
睡 眠
EEG、EOG、EMG
慢波睡眠(slow wave sleep,SWS)非快速眼球运动睡眠(non-REM sleep,NREM sleep)
异相睡眠(paradoxical sleep,PS)快波睡眠(fast wave sleep,FWS)或快速眼球运动睡眠(rapid eye movement sleep,REM sleep)
Representative electroencephalographic (EEG) tracing and corresponding sleep stages
20%-25%
30%-40%
15%-20%
睡眠的发生机制
Representation of the ‘‘flip-flop’’ switch mechanism that regulates sleep–wake-cycle
The suprachiasmatic nucleus (SCN), by receiving the information from light and dark environmental stimuli through the retina, regulates the secretion of melatonin produced by the pineal gland. Tryptophan starts the synthesis of melatonin through intermediates (5-hydroxytryptophan,serotonin, and N-acetylserotonin). RHT retinohypothalamic tract
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