渐进式直立活动对ICU呼吸机依赖患者成功撤机的影响  

Effect of gradual upright activities on weaning of ICU patients depending on ventilators

作　　者：黄海燕[1] 罗健[2] 徐玉兰[2] 李菠[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院重症医学科,湖北武汉430022 [2]华中科技大学同济医学院附属协和医院护理部,湖北武汉430022

出　　处：《护理学杂志》2014年第24期19-21,共3页

基　　金：湖北省自然科学基金项目(2013CFB145)

摘　　要：目的 探讨渐进式直立活动方案在ICU呼吸机依赖患者撤机过程中的作用.方法 将80例ICU呼吸机依赖患者随机分为观察组和对照组各40例.对照组采用常规撤机方法,观察组在此基础上采用渐进式直立活动方案进行撤机,具体包括：第一步抬高床头、用软枕将双腿支撑1～2 h;第二步做好常规护理后,吸净患者气道内痰液后做脱机训练,然后将患者身体调整成坐立姿势,双足垂于床下;第三步将患者移至床旁椅子上;依此循序渐进,直至成功撤机.结果 两组撤机成功率、呼吸机使用天数及呼吸机相关性肺炎发生率比较,差异有统计学意义（P＜0.05,P＜0.01）.结论 渐进式直立活动能显著提高ICU呼吸机依赖患者撤机成功率,减少并发症发生率,缩短住院时间。Objective To explore the effect of gradual upright activities on weaning of ICU patients depending on ventilators.Methods Totally 80 ventilator dependent patients in ICU were randomly divided into an experimental group （n =40） and a control group （n =40）.The control group was weaned from the ventilator by conventional approach,while the experimental group was weaned by additionally using gradual upright activities,which included three steps of raising the head of the beds combined with putting pa tients＇legs high（supported with a soft pill） for 1～2 h,then letting patients keep a sitting posture with their feet hanging in the air after sucking up sputum in the airway and doing training to facilitate weaning,as well as moving patients to bedside chairs.The average hospitalization days,length of ICU stay,average days of using ventilators,and the incidence of VAP and rate of successful weaning of the two groups were compared.Results The average hospitalization days,length of ICU stay,average days of using ventilators,the incidence of VAP and rate of successful weaning of the experimental group were significantly lower than the control group （P＜0.05,P＜0.01）.Conclusion Progressive upright activity program can significantly increase the rate of successful weaning,reduce the rate of complications and shorten hospital stay days for patients in ICU.

关 键 词：ICU 呼吸机依赖 渐进式直立活动 撤机 

分 类 号：R471[医药卫生—护理学] R452[医药卫生—临床医学]