ICU机械通气患者早期四级康复训练效果  

Effectof early level 4 rehabilitation training for patients with mechanical ventilation in ICU

作　　者：黄海燕[1] 王小芳[1] 罗健[2] 胡莉[1] 邹晓静[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教研室,湖北武汉430022

出　　处：《护理学杂志》2016年第15期1-5,共5页Journal of Nursing Science

摘　　要：目的探讨ICU机械通气患者早期四级康复训练的实施效果。方法将100例入住综合ICU的重症患者随机分为干预组和对照组各50例,对照组按ICU护理常规给予四肢被动活动和功能锻炼,干预组在机械通气24h内开始实施早期四级康复训练。干预后对两组肌力变化、Barthel指数、机械通气时间、ICU住院时间、总住院时间、ICU获得性肌无力发生率、呼吸机相关性肺炎发生率、深静脉血栓发生率、压疮发生率进行评估。结果干预组出院前1天肌力、Barthel指数评分显著高于对照组,机械通气时间、ICU住院时间、总住院时间显著短于对照组,ICU获得性肌无力、呼吸机相关性肺炎发生率显著低于对照组(P<0.05,P<0.01)。结论早期四级康复训练可提高ICU机械通气患者的肌力和自理能力,预防患者获得性肌无力的发生,缩短住院时间,利于患者早日康复。Objective To discuss the effect of early level 4 rehabilitation training for patients with mechanical ventilation in ICU. Methods A total of 100 critically ill patients in general ICU were randomized into an intervention group and a control group, with 50 patients in each group. The control group used 4 limbs passive activities and functional exercise according to ICU conventional nursing, while the intervention group started early level 4 rehabilitation training within 24 hours using mechanical ventilation. The muscle strength change, Barthel index, the time of mechanical ventilation, the length of stay in ICU, the total length of hospital stay, and the incidence of ICU acquired weakness （ICU-AW）, ventilator associated pneumonia （VAP）, deep vein thrombosis （DVT） as well as pressure ulcers were assessed after the intervention for the two groups. Results At 1 day before discharge, the muscle strength, Barthel index score in the intervention group were significantly higher than those in the control group, the time of mechanical ventilation, the length of stay in ICU, the total length of hospital stay were significantly shorter than the control group, and the incidences of ICU-AW and VAP were significantly lower than the control group （P〈0.05, P〈0.01）. Conclusion Early level 4 rehabilitation training can improve muscle strength and self care ability for patients with mechanical ventilation in ICU, prevent ICU-AW, shorten the length of hospital stay, and is benefit for earlier recovery.

关 键 词：ICU 机械通气患者 获得性肌无力 早期活动 康复训练 

分 类 号：R473.3[医药卫生—护理学]