综合功能锻炼对住院危重肌肉萎缩患者脱机后再插管的影响  

Effect of comprehensive functional exercise on intubation after offline inpatients with severe muscle atrophy

作　　者：王妍妍[1] 徐宏[2] 闫岩[3] 史景玉 杨帆[5] Wang Yanyan;Xu Hong;Yan Yan;Shi Jingyu;Yang Fan(Intensive Care Unit,the Second Affiliated Hospital of Harbin Medical University,Harbin 150000,China;Nursing Department,the First Affiliated Hospital of Qiqihar,Qiqihar 161000,China;Cosmetology Department,the First Affiliated Hospital of Qiqihar 161000,China;Intensive Care Unit,the First Affiliated Hospital of Qiqihar,Qiqihar 161000,China;Pediatrics Quiescent Room,the Second Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第二医院ICU,150000 [2]哈尔滨医科大学附属第二医院门诊儿科静点室,150000 [3]齐齐哈尔市第一医院护理部,161000 [4]齐齐哈尔市第一医院美容科,161000 [5]齐齐哈尔市第一医院ICU,161000

出　　处：《中国实用护理杂志》2019年第9期681-684,共4页Chinese Journal of Practical Nursing

摘　　要：目的探究综合功能锻炼对住院肌肉萎缩患者脱机后再插管的影响。方法选取2016年1月至2018年1月于哈尔滨医科大学附属二院接受治疗的92例肌肉萎缩患者为研究对象,按照护理方法将患者分为对照组和观察组各46例,对照组采取常规肌肉萎缩锻炼,观察组在对照组的基础上加以综合功能锻炼。比较2组患者呼吸机拔管后48、72、168h再插管率、危象发生率、呼吸机上机率、并发症发生率以及脱机时间、SF-36健康状况评分。结果观察组患者48、72、168h再插管例数分别为0、1、2例,对照组分别为5、10、13例,差异有统计学意义(χ^2=5.287、8.364、9.478,P<0.05或0.01)。观察组危象发生率、呼吸机上机率、并发症发生率分别为8.70%(4/46)、4.35%(2/46)、4.35%(2/46),对照组分别为23.91%(11/46)、30.23%(13/46)、19.57%(9/46),差异有统计学意义(χ^2=8.791、9.478、7.325,P<0.01或0.05)。观察组脱机时间为(107.22±10.98)h,对照组为(199.44±10.57)h,差异有统计学意义(t=2.413,P<0.05)。观察组采用中文版健康状况问卷(SF-36)健康状况评分生理职能、身体疼痛、社会功能、情感职能、精神状态分别为(36.12±10.44)、(82.20±10.24)、(40.43±16.14)、(63.88±9.75)、(82.06±10.11)分,对照组分别为(26.68±17.26)、(67.33±10.66)、(26.78±10.72)、(42.18±8.79)、(68.92±9.65)分,2组比较差异有统计学意义(t=12.214~14.829。P<0.05)。结论综合功能锻炼有利于降低肌肉萎缩患者脱机后再插管率,降低患者不良事件发生率,提高患者健康水平。Objective To explore the effect of comprehensive functional exercise on re-intubation in hospitalized patients with critical muscle wasting.MethodsA total of 92 patients with severe muscle atrophy who were treated in our hospital from January 2016 to 2018 were selected.According to the nursing method,the patients were divided into two groups,including 46 cases in the control group,routine muscle atrophy exercise,and 46 cases in the observation group.Comprehensive functional exercise was performed on the basis of the control group.The control group took regular muscle atrophy exercises,and the observation group took a comprehensive functional exercise on the basis of the control group.The reintubation rates at 48h,72h,and 168h after extubation were compared between the two groups;the incidence of crisis,ventilator prevalence,occurrence rate,and off-line time were compared between the two groups;the health status of SF-36 was compared between the two groups.ResultsThere were 0,1,and 2 patients in the observation group at 48,72,and 168h,and 5,10,and 13 patients in the control group,respectively,with statistically significant differences(χ^2=5.287,8.364,9.478,P<0.05 or 0.01).The incidence rate of crisis,ventilator probability and complication rate were 8.70%(4/46),4.35%(2/46)and 4.35%(2/46)in the observation group,and 23.91%(11/46),30.23%(13/46)and 19.57%(9/46)in the control group,respectively.The difference was statistically significant(χ^2=8.791,9.478,7.325,P<0.05).The off-line time of the observation group was(107.22±10.98)h,and that of the control group(199.44±10.57)h,with statistically significant difference(t=2.413,P<0.05).The SF-36 health status score of the observation group was respectively 36.12±10.44,82.20±10.24,40.43±16.14,63.88±9.75,82.06±10.11,and the control group was 26.68±17.66,26.78±10.72,42.18±8.79,and 68.92±9.65.The difference between the two groups was statistically significant(t=12.214-14.829,P<0.05).ConclusionsComprehensive functional exercise is beneficial to reduce the rate of in

关 键 词：肌疾病 萎缩性 综合功能锻炼 脱机后再插管 

分 类 号：R473[医药卫生—护理学]