两种不同解除约束方案对降低ICU获得性衰弱发生率的影响研究  

Effect of two different constraint relief schemes on reducing the incidence of ICU-acquired weakness

作　　者：宋文静[1] 李赛 司梅梅 惠彩红[1] 朱艳飞[1] 王莹[1] Song Wenjing;Li Sai;Si Meimei;Hui Caihong;Zhu Yanfei;Wang Ying(Department of Critical Medicine,Tianjin First Central Hospital,Tianjin,300192)

机构地区：[1]天津市第一中心医院重症医学科,天津300192

出　　处：《护士进修杂志》2021年第15期1349-1353,共5页Journal of Nurses Training

基　　金：天津市护理学会科研课题(编号:tjhlky2020QN07);天津市第一中心医院科技基金项目(编号:2019CF31)。

摘　　要：目的探讨两种不同的解除约束方案对降低重症监护病房(Intensive care unit,ICU)患者ICU获得性衰弱(Intensive care unit acquired weakness,ICU-AW)发生率的影响。方法采用便利抽样法,选取我院ICU收治的需实施身体约束的气管插管患者196例,按随机数字表法分为对照组与观察组,对照组98例,应用常规解除约束方案;观察组98例,应用基于ICU约束决策轮制定的解除约束方案,比较两组患者的ICU-AW发生率、约束时间、约束并发症及非计划性拔管发生率。结果观察组患者的ICU-AW发生率为29.59%,对照组为43.88%;非计划性拔管发生率观察组为1.02%,对照组为4.08%。观察组的ICU-AW发生率、身体约束并发症、平均约束时间及身体约束率均低于对照组,差异均有统计学意义(P<0.05),而两组患者的非计划性拔管发生率比较,差异无统计学意义(P>0.05)。结论基于ICU约束决策轮的解除约束方案应用于ICU气管插管患者可降低身体约束率,缩短约束时间,降低ICU-AW发生率,减少身体约束损伤,同时不增加非计划性拔管发生率。Objective To investigate the effect of two different restraint release schemes on reducing the incidence of ICU-AW.Methods A total of 196 patients with tracheal intubation who needed physical restraint were selected by convenient sampling method and randomly divided into control group and observation group according to random number table method,The control group(98 cases)was given the conventional unconstrained scheme,and the observation group(98 cases)was applied the constraint release scheme based on ICU constraint decision-making round.The incidence of ICU-AW,restraint time,constraint complications and unplanned extubation were compared between the two groups.Results The incidence of ICU-AW was 29.59% in the observation group and 43.88% in the control group;The incidence of unplanned extubation was 1.02% in the observation group and 4.08% in the control group,The ICU-AW incidence,physical restraint complications,average restraint time and physical restraint rate of the observation group were lower than those of the control group and the differences were statistically significant(P<0.05),There was no significant difference in the incidence of unplanned extubation between the two groups(P>0.05).Conclusion The application of the constraint release scheme based on ICU constraint decision-making wheel in ICU patients with endotracheal intubation can reduce the physical restraint rate,shorten the constraint time,reduce the incidence of ICU-AW,reduce the physical restraint injury,and do not increase the incidence of unplanned extubation.

关 键 词：身体约束 气管插管 重症监护病房 获得性衰弱 非计划性拔管 肌力 约束并发症 

分 类 号：R473[医药卫生—护理学]