基于4E模式的ICU早期康复方案在机械通气患者中的应用  

Effects of the early rehabilitation programme based on 4E model on critically ill patients receiving mechanical ventilation

作　　者：于红静[1] 卢青云 黎婉婷 覃湘君 徐天莹 YU Hongjing;LU Qingyun;LI Wanting;QIN Xiangjun;XU Tianying(Nursing Department of the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,510260,China)

机构地区：[1]广州医科大学附属第二医院护理部,广州市510260 [2]广州医科大学附属第二医院重症医学科,广州市510260 [3]中山大学南方学院护理与健康学院

出　　处：《中国护理管理》2021年第3期337-342,共6页Chinese Nursing Management

基　　金：广东省医学科研基金项目(A2020242)。

摘　　要：目的:分析基于4E模式的ICU早期康复方案在机械通气患者中的应用效果。方法:采用便利抽样法,选取某医院2个ICU病区收治的74例患者为研究对象,ICU一区患者为实验组(n=38),ICU二区患者为对照组(n=36)。对照组接受常规康复护理,实验组接受基于4E模式的ICU早期康复方案。结果:两组患者在ICU谵妄发生率、谵妄持续时间、医学研究理事会肌力评分、ICU获得性衰弱(ICU-AW)发生率、机械通气时间、ICU住院时间、总住院时间等方面差异均有统计学意义(P<0.05)。在实施过程中,实验组患者未发生早期康复相关的严重不良事件。结论:对机械通气患者实施基于4E模式的ICU早期康复方案安全可行且有效,可改善患者肌力,降低ICU-AW及ICU谵妄发生率,缩短ICU谵妄持续时间、机械通气时间、ICU住院时间与总住院时间。Objective:To explore the effects of the 4 E-based ICU early rehabilitation programme on critically ill patients undergoing mechanical ventilation to provide scientific basis for future clinical practice.Methods:Totally 74 critically ill patients given mechanical ventilation admitted to 2 wards in ICU were recruited by convenience sampling.Patients in Ward 1 was assigned to the experimental group(n=38)and patients in Ward 2 was assigned to the control group(n=36).The control group received routine rehabilitation nursing,while the experimental group received the intervention of early rehabilitation programme based on 4 E model.Results:Outcomes including the incidence and duration of ICU delirium,muscle strength scores assessed using Medical Research Council Muscle Strength Grading System,the incidence of Intensive Care Unit Acquired Weakness(ICU-AW),mechanically ventilation duration,duration of ICU stay and the total Length Of Stay(LOS)in hospital of the experimental group were significantly better than those of the control group(P<0.05).No severe early rehabilitation-related adverse events were observed in the experimental group.Conclusion:The early rehabilitation programme based on 4 E model is a safe,feasible and effective approach,which can not only improve patients’muscle strength and their activities of daily living,but also reduce the incidence of ICU-AW,decrease the incidence and duration of ICU delirium,and shorten the mechanical ventilation time,ICU stay and the total LOS in hospital.

关 键 词：重症监护室 机械通气患者 早期康复 4E模式 护理 

分 类 号：R47[医药卫生—护理学]