危重症患者早期康复治疗的临床疗效  

Clinical Effect of Early Rehabilitation Treatment for Critically Ill Patients

作　　者：王英[1] 孙海梅[1] 唐坤[1] 代蓉[2] WANG Ying;SUN Hai-mei;TANG Kun;DAI Rong(Intensive Care Unit,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China;Dept.of Rehabilitation,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院重症医学科,云南昆明650032 [2]昆明医科大学第一附属医院康复科,云南昆明650032

出　　处：《昆明医科大学学报》2020年第8期134-138,共5页Journal of Kunming Medical University

基　　金：云南省科技计划项目重大科技专项(生物医药)基金资助项目(2018ZF009)。

摘　　要：目的探讨早期康复治疗对重症医学科急危重症患者的疗效和安全性。方法选择2016年7月至2019年6月昆明医科大学第一附属医院重症医学科住院的患者150例,随机分为对照组和康复治疗组,对照组采用ICU常规治疗,康复治疗组在ICU常规治疗基础上同时接受由专业康复团队(由ICU医生、护士、康复科医师、康复治疗师组成)进行的早期康复治疗(入住ICU48 h内),比较两组呼吸循环情况(心率、血压、血氧饱和度)及不良事件(坠床、管路脱出、压疮、深静脉血栓、肺栓塞)的发生情况,病死率、机械通气时间、住ICU时间、谵妄发生率、肌力恢复情况。结果两组患者循环功能(血压、心率)及深静脉血栓、肺栓塞、坠床、管路脱出不良事件比较,差异无统计学意义(P> 0.05);血氧饱和度、压疮比较,差异有统计学意义(P <0.05);康复组机械通气时间、ICU入住时间、肌力比较,差异有统计学意义(P <0.01);谵妄发生率、死亡率比较差异有统计学意义(P <0.05)。结论 ICU危重症患者早期进行康复治疗能显著缩短ICU住院时间、机械通气时间,增加肌力恢复、降低谵妄发生率、死亡率,提高危重症患者的生存生活能力,对危重症患者早期进行康复治疗是安全有效的。Objective To explore the efficacy and safety of early rehabilitation treatment for critical patients in the intensive care department. Methods 150 patients who were admitted to the intensive care department of our hospital from July, 2016-2019 to June, 2016 were chosen as the study subjects. Randomized digital table method was used to classify the rehabilitation treatment group and the control group. The control group was treated with ICU routine treatment. And the rehabilitation treatment group received early rehabilitation treatment by professional rehabilitation team(composed of ICU doctors, nurses, rehabilitation specialists and rehabilitative therapists) on the basis of routine treatment of ICU(within 48 hours after staying in ICU). The respiration, circulations(heart rate, blood pressure and oxygen saturation), adverse events(dropping from the bed, lines’ loosing out,pressure sores, deep venous thrombosis and pulmonary embolism), case fatality rate, the duration of ventilatory support, ICU stay time, delirium incidence and muscle strength recovery between two groups were compared.Results The difference of circulatory function(blood pressure, heart rate), deep venous thrombosis,pulmonary embolism,dropping from the bed, lines’ loosing out and other adverse events between the two groups was not statistically significant(P > 0.05). The differences of oxygen saturation and pressure sores(P < 0.05)were statistically significant. The differences of mechanical ventilation time, ICU stay time and muscle force(P <0.01) in the recovery group were statistically significant. The differences of delirium incidence and death rate(P <0.05) were statistically significant. Conclusion Early rehabilitation treatment of ICU critically ill patients can significantly shorten ICU stay time and the duration of ventilatory support, increase muscle strength recovery,decrease delirium incidence, death rate and improve the survival and living ability of the critically ill patients. So early rehabilitation of critically ill patients

关 键 词：急危重症患者 早期康复治疗 康复时机 

分 类 号：R493[医药卫生—康复医学]