肺康复分级疗法联合过渡期护理在预防机械通气患者ICU后综合征中的应用效果  

Application ef fect of graded pulmonary rehabilitation therapy combined with transitional nursing in preventing post-ICU syndrome in patients with mechanical ventilation

作　　者：汪璐璐 徐凤玲[1] 宫娟[1] 刘钢[1] 方俊[1] 张标新[1] WANG Lulu;XU Fengling;GONG Juan;LIU Gang;FANG Jun;ZHANG Biaoxin(The First Affiliated Hospital of Anhui Medical University,Hefei,230022,China)

机构地区：[1]安徽医科大学第一附属医院,安徽省合肥市230022

出　　处：《护理实践与研究》2022年第21期3170-3176,共7页Nursing Practice and Research

基　　金：2019年度国家自然科学基金院内青年培育计划项目基金资助(编号:2019kj23)。

摘　　要：目的探讨肺康复分级疗法联合过渡期护理在预防机械通气患者ICU后综合征中的应用效果。方法选取2021年1—12月于医院ICU转出的120例机械通气患者为研究对象,按组间基本特征具有可比性的原则分为观察组和对照组,每组60例。对照组采用常规治疗护理,观察组在对照组基础上采用肺康复分级疗法联合过渡期护理。比较两组患者在肺康复前、转出ICU时及转出后1周的生活自理能力、氧合指数、肌力、ICU获得性衰弱、焦虑、抑郁、谵妄及不良事件发生率。结果双因素方差分析结果显示,两组患者在肺康复前、转出ICU时及转出后1周三个时间点生活自理能力评分、肌力评分及氧合指数呈逐渐升高的趋势,焦虑与抑郁评分呈逐渐降低的趋势,时间之间差异有统计学意义(P_(时间)<0.05);转出ICU时、转出ICU 1周后,生活自理能力评分、肌力评分及氧合指数观察组高于对照组,焦虑与抑郁评分观察组低于对照组,差异有统计学意义(P_(组间)<0.05)。转出后1周,观察组ICU获得性衰弱、谵妄、非计划拔管发生率低于对照组,差异有统计学意义(P<0.05)。结论应用肺康复分级疗法联合过渡期护理对ICU机械通气患者实施干预,可降低ICU后综合征发生风险,短期可有效改善ICU转出患者的躯体、心理及认知功能,降低转出后1周非计划拔管发生率。Objective To explore the application effect of graded pulmonary rehabilitation therapy combined with transitional nursing in preventing post-ICU syndrome in patients with mechanical ventilation.Methods A total of 120 patients with mechanical ventilation transferred from ICU in the hospital from January to December 2021 were selected as the research objects.According to the principle of comparability of basic characteristics between groups,they were divided into observation group and control group,with 60 cases in each group.The control group received conventional treatment and nursing,the observation group received graded pulmonary rehabilitation therapy combined with transitional nursing based on the control group.The self-care ability,oxygenation index,muscle strength,ICU acquired weakness,anxiety,depression,delirium and incidence of adverse events were compared between the two groups before pulmonary rehabilitation,at the time of ICU transfer and 1 week after ICU transfer.Results Twofactor variance analysis,according to the results of two groups of patients in the ICU pulmonary rehabilitation before,transfered out,transfered out 1 week three time points after life self-care ability score and oxygenation index showed a trend of increased,strength grade and anxiety and depression scores showed a trend of gradually reducing and time between the difference was statistically signifi cant(P<0.05).At the time of ICU transfer and 1week after ICU transfer,the self-care ability score and oxygenation index of the observation group were higher than the control group,and the muscle strength score and anxiety and depression score of the observation group were lower than the control group,the dif ferences were statistically signifi cant(P<0.05).One week after transfer,the incidence of ICU-acquired weakness,delirium and unplanned extubation in the observation group was lower than the control group,the differences were statistically significant(P<0.05).Conclusion Graded pulmonary rehabilitation therapy combined with transition

关 键 词：肺康复分级疗法 过渡期护理 机械通气 ICU后综合征 生活自理能力 

分 类 号：R473.56[医药卫生—护理学]