eCASH理念结合早期活动在ICU机械通气患者的应用研究  

Application of the eCASH concept combined with early mobilization strategies in ICU patients with mechanical ventilation

作　　者：卞红 刘海英[2] 杨正宇[1] 张婧婧[2] 罗亮[1] 俞萍[1] Bian Hong;Liu Haiying;Yang Zhengyu;Zhang Jingjing;Luo Liang;Yu Ping(ICU of the Second People′s Hospital of Wuxi,Nanjing Medical University,Wiuci 214000,China)

机构地区：[1]南京医科大学附属无锡市第二人民医院重症医学科,江苏无锡214000 [2]南京医科大学附属无锡市第二人民医院护理部,江苏无锡214000

出　　处：《护理学杂志》2019年第10期38-41,共4页Journal of Nursing Science

基　　金：无锡市卫生计生委医学重点人才培育对象项目(ZDRCPY017);南京医科大学科技发展基金项目(NMUB2018238)

摘　　要：目的探讨eCASH理念结合早期活动在ICU机械通气患者中的应用效果。方法将96例ICU机械通气患者按入院时间分为对照组和观察组各48例,对照组给予常规镇痛镇静及护理,观察组实施基于eCASH理念的舒适化浅镇静管理结合早期活动。结果观察组谵妄发生率和ICU获得性衰弱发生率显著低于对照组,MRC肌力评分显著高于对照组,机械通气时间和ICU住院天数显著短于对照组(P<0.05,P<0.01)。结论 eCASH理念结合早期活动应用于ICU机械通气患者,可降低患者谵妄和ICU获得性衰弱,缩短机械通气和ICU入住时间,促进患者康复。Objective To evaluate the effect of comfort and patient-centred care without excessive sedation(eCASH) concept combined with early mobilization in the critically ill receiving mechanical ventilation in ICU. Methods Ninety-six critically ill patients with mechanical ventilation were assigned into two groups chronologically, with 48 in each. The control group was given routine analgesia and sedation, as well as routine nursing care, while the observation group received eCASH concept based nursing care and early mobilization strategies. Results The observation group had lower incidence of delirium and ICU acquired weakness, higher Medical Research Council(MRC) score, and shorter mechanical ventilation and ICU stay compared with the control group(P<0.05, P<0.01). Conclusion Application of eCASH concept combined with early mobilization strategies in patients with mechanical ventilation can effectively reduce delirium and ICU acquired weakness, shorten mechanical ventilation and ICU stay, and contribute to recovery of patient.

关 键 词：ICU 机械通气 镇痛 镇静 eCASH理念 早期活动 舒适护理 谵妄 ICU获得性衰弱 

分 类 号：R473.5[医药卫生—护理学]