肢体功能锻炼强度对外科ICU患者康复效果的影响  

Effect of early exercise on the rehabilitation of critically ill patients in the surgical intensive care unit

作　　者：叶向红[1] 江方正[1] 郑桃花[1] 彭南海[1] 李维勤[1] 

机构地区：[1]南京军区南京总医院全军普通外科研究所,南京市210002

出　　处：《中华护理杂志》2014年第2期143-147,共5页Chinese Journal of Nursing

基　　金：国家自然科学基金资助项目(编号:81200334);南京军区南京总医院课题(编号:2012075)

摘　　要：目的研究运用卧床运动治疗器加强功能锻炼在外科危重患者康复中的作用。方法将外科ICU允许进行床上功能锻炼的危重患者100例随机分为2组,患者急性生理与慢性健康评分表(APACHEⅡ)评分均≥8分,预计卧床≥7d。实验组采用自行设计的卧床运动治疗器,自运动开始5d内达目标运动量;对照组采用常规床上锻炼方法。结果 2组锻炼前后体重比较,差异无统计学意义。实验组的肌肉总量和骨骼肌从锻炼后第7天开始与对照组相比有显著增加,差异有统计学意义(P<0.01或P<0.05);第7、14天实验组脂肪含量、躯干和四肢水分较对照组下降,差异有统计学意义(P<0.01或P<0.05);实验组锻炼第14天白蛋白水平较对照组提高(P<0.05);实验组免疫指标(CD4/CD8)从锻炼第3天即开始升高,第7天、14天与对照组相比提高明显(P<0.01);实验组首次下床时间、住ICU时间少于对照组,差异有统计学意义(P<0.01)。结论借助卧床运动治疗器促进卧床患者进行主动功能锻炼,操作简便,易于掌握,节省护士工作量,有助于促进重症患者的康复。Objective To evaluate the effects of bedside exercise therapeutic equipment in the rehabilitation of critically ill patients in the surgical intensive care unit（SICU）. Methods One-hundred critically ill patients in SICU who were allowed to take functional exercise in bed were randomly divided into two groups. The patients＇ APACHEⅡscore were ≥8 and were expected to be in bed for more than seven days. The patients in the experimental group performed exercise using a self-designed bedside exercise therapeutic equipment and achieved to the target amount of exercise within five days,while the patients in the control group performed routine exercise. Results No significant differences were found in the body weight between the two groups before and after exercise（P0.05）.Compared with the control group,the muscle content and skeleton muscle in the experimental group were significantly higher after taking exercise for 7 days（P0.01 or P0.05）;the fat content,moisture of trunk and limbs in the experimental group were significantly lower after taking exercise for 7 days and 14 days（P0.01 or P0.05）; the serum albumin level in the experimental group was significantly higher after taking exercise for 14 days（P0.05）;the immunity index（CD4/CD8） in the experimental group started to increase since the third day,and increased markedly after taking exercise for 7 days and 14 days（P0.01）. Moreover,the mechanical ventilation time and ICU stays in the experimental group were significantly shorter than those of the control group. Conclusion The bedside exercise therapeutic equipment can facilitate the patients to take active functional exercise in beds. It is simple to operate and easy to master,which saves the workload of nurses and helps to fasten the recovery of critically ill patients.

关 键 词：身体锻炼 康复 危重病人医疗 

分 类 号：R473.6[医药卫生—护理学]