早期四级锻炼结合ESCAPE策略规范化镇静唤醒对ICU机械通气患者免疫功能及四肢肌力的影响  

Effects of early four-level exercise combined with ESCAPE strategy,standardized sedation and arousal on the immune function and muscle strength of limbs in mechanically ventilated ICU patients

作　　者：李文涵 郭立敏 LI Wenhan;GUO Limin(Intensive Care Unit,Zhengzhou Orthopedic Hospital,Zhengzhou 450000,Henan)

机构地区：[1]郑州市骨科医院重症监护室,河南郑州450000

出　　处：《华夏医学》2021年第5期107-111,共5页Acta Medicinae Sinica

摘　　要：目的:探讨早期四级锻炼结合ESCAPE策略规范化镇静唤醒对ICU机械通气患者免疫功能及四肢肌力的影响。方法:选取113例ICU机械通气患者,按照干预方式的不同分成两组,对照组66例采用ESCAPE策略规范化镇静唤醒,观察组67例在对照组基础上联合早期四级锻炼方式,对比两组意识状态、免疫功能、四肢肌力。结果:观察组患者完全清醒时间短于对照组,谵妄发生率、谵妄状态持续时间均低于对照组(P<0.05);干预后,两组血清CD4^(+)/CD8^(+)水平均升高,TNF-α、IL-8水平均降低,观察组升高、降低幅度分别大于对照组(P<0.05);干预后,观察组MRC肌力评分高于对照组,ICU-AW发生率低于对照组(P<0.05)。结论:早期四级锻炼结合ESCAPE策略规范化镇静唤醒能有效促进ICU机械通气患者的意识恢复,改善免疫功能,提升四肢肌力。Objective:To investigate the effects of early four-level exercise combined with ESCAPE strategy,standardized sedation and arousal on the immune function and limb muscle strength of mechanically ventilated ICU patients.Methods:113 mechanically ventilated ICU patients were divided into two groups according to different intervention methods.,66 patients in the control group were treated with ESCAPE strategy standardized sedation and arousal,while another 67 patients in the observation group were treated additional early four-level exercise on the basis of the treatment for the control group.The consciousness,immune function and muscle strength of limbs in patients were compared between both groups.Results:The complete awake time in the observation group was shorter than that of the control group,the incidence and duration of delirium was lower than that of the control group(P<0.05);the serum CD4^(+)/CD8^(+)levels increased after intervention in the two groups,while TNF-Αand IL-8 levels decreased,but the increase and decrease degree of the observation group were larger than that of the control group(P<0.05);after intervention,the MRC muscle strength score of the observation group was higher than that of the control group,and the incidence of ICU-AW was lower than that of the control group(P<0.05).Conclusion:Early four-level exercise combined with ESCAPE strategy,standardized sedation and arousal can effectively promote the recovery of consciousness in mechanically ventilated ICU patients,improve the immune functions and enhance the limb muscle strength of patients.

关 键 词：早期四级锻炼 ESCAPE策略 ICU机械通气 免疫功能 四肢肌力 

分 类 号：R473.5[医药卫生—护理学]