电针联合早期活动在ICU有创机械通气患者早期肺康复中的疗效观察  

Clinical Study of Electroacupuncture Combined with Early Activity in Early Lung Rehabilitation in Intubated ICU Patients

作　　者：耿艳霞[1] 陈栋[1] 蒋华[1] 刘志敏[1] 张海东[1] 王醒[1] 

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中国中医急症》2017年第11期2034-2037,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省自然科学基金(BK20151044);江苏省中医院课题(Y17013)

摘　　要：目的观察电针联合早期活动对重症医学科(ICU)中有创机械通气患者预后的影响。方法将患者51例按随机数字表法分为对照组25例与观察组26例,观察组患者每日进行2次电针及床上/床旁活动,活动时间和强度根据患者病情调整,早期活动包括被动全范围关节活动、被动/主动足蹬式下肢活动锻炼、床旁坐位、床旁站立和床旁行走。比较两组患者的首次床旁坐位时间、机械通气时间、ICU住院时间、住院病死率、出ICU时握力和Barthel指数。结果两组患者住院病死率差异无统计学意义(P>0.05),观察组首次床旁坐位时间、机械通气时间、ICU住院时间均明显短于对照组(P<0.05),观察组患者出ICU时握力和Barthel指数明显高于对照组(P<0.05),电针及早期活动施行期间未发生严重不良事件。结论机械通气患者在ICU住院期间进行早期肺康复安全可行,可明显改善患者预后。Objective： To investigate the effects of eleetroacupuncture combined with early activity on the prog- nosis of patients with invasive mechanical ventilation in intensive care unit （ICU）. Methods： 51 patients were randomly divided into the control group （25 cases） and the observation group （26 cases）. Patients in the observa- tion group were given electroacupuncture and bed or bedside activities twice per day. The activity time and inten- sity were adjusted according to the patients＇ condition. Early activities included passive full-range joint activity, passive or active pedal movement,bedside sitting,bedside standing and bedside walking. Days out of bed for the first time, mechanical ventilation time, ICU hospitalization time, hospital mortality, grip strength, and Barthel index were compared between two groups. Results： There was no significant difference in the hospital mortality between two groups. The first out of bed time, meehanical ventilation time and ICU stay time in the observation group were significantly shorter than those in the control group （P〈 0.05）. In the observation group, grip strength and Barthel index were significantly higher than those in the control group （P〈 0.05）. There were no serious adverse events during electroacupuncture and early aetivity. Conclusion： It＇s safe and feasible for patients with mechanical ven- tilation to carry out early lung rehabilitation during ICU hospitalization,which can significantly improve the prog- nosis of patients.

关 键 词：肺康复 电针 早期活动 有创机械通气 

分 类 号：R245.97[医药卫生—针灸推拿学]