早期主动活动护理在行机械通气重症肌无力患者中的应用效果  

Application effect of early active movement nursing in myasthenia gravis patients undergoing mechanical ventilation

作　　者：戴秀 谢云香 田玉洁 DAI Xiu;XIE Yunxiang;TIAN Yujie(Department of Critical Care Medicine,The Second Hospital,University of South China,Hengyang,Hunan,421001,China)

机构地区：[1]南华大学附属第二医院重症医学科,湖南衡阳421001

出　　处：《中西医结合护理（中英文）》2022年第8期13-16,共4页Journal of Clinical Nursing in Practice

摘　　要：目的探讨早期主动活动护理在行机械通气重症肌无力患者中的应用效果。方法选取2019年4月至2021年6月于南华大学附属第二医院行机械通气的86例重症肌无力患者为研究对象,按照随机数字表法将其分成观察组(43例)和对照组(43例)。对照组患者给予细化护理,观察组患者在对照组护理方法的基础上给予早期主动活动护理。比较2组患者的脱机时间、重症监护室(ICU)入住时间、重症肌无力严重程度、基本日常生活能力和并发症发生情况。结果观察组的脱机时间早于对照组,ICU入住时间短于对照组(P均<0.05)。护理2周后及出院时,2组的重症肌无力严重程度量表(MGFA-QMG)和Katz日常生活功能指数量表(Katz-ADL)评分均低于入院时(P均<0.05);出院时,2组的MGFA-QMG和Katz-ADL评分均低于护理2周后(P均<0.05);观察组在护理2周后及出院时的MGFA-QMG和Katz-ADL评分均低于同期对照组(P均<0.05)。观察组腹痛、肾功能不全和肝功能不全等并发症的总发生率为4.65%,低于对照组的18.60%(P<0.05)。结论早期主动活动护理能有效缩短重症肌无力患者的机械通气时间和恢复时间,减轻其重症肌无力严重程度,提升其基本日常生活能力,减少并发症的发生。Objective To explore the application effect of early active movement nursing in patients with myasthenia gravis undergoing mechanical ventilation.Methods Eighty-six myasthenia gravis patients who underwent mechanical ventilation at the Second Hospital,University of South China from April 2019 to June 2021 were selected for the study.They were allocated into an observation group(43 cases)and a control group(43 cases)by using a random number table.The patients in the control group were given refined nursing,and the patients in the observation group were given early active movement nursing in addition to the nursing method of the control group.The duration of mechanical ventilation,intensive care unit(ICU)length of stay,severity of myasthenia gravis,basic activities of daily living,and complications were compared between the two groups.Results The duration of mechanical ventilation and ICU length of stay in the observation group were shorter than those in the control group(both P<0.05).After 2 weeks of nursing and at discharge,the scores of the Myasthenia Gravis Foundation of America-Quantitative Myasthenia Gravis(MGFA-QMG)and Katz Index of Activities of Daily Living(Katz-ADL)in both groups were lower than those at admission(all P<0.05).At discharge,the scores of the MGFA-QMG and Katz-ADL in both groups were lower than those after 2 weeks of nursing(all P<0.05).The observation group had lower MGFA-QMG and Katz-ADL scores than the control group after 2 weeks of nursing and at discharge(all P<0.05).The total incidence of complications such as abdominal pain,renal insufficiency,and hepatic insufficiency in the observation group was 4.65%,which was lower than 18.60%in the control group(P<0.05).Conclusion Early active movement nursing can effectively shorten the duration of mechanical ventilation and recovery time of patients with myasthenia gravis,reduce the severity of myasthenia gravis,enhance the basic activities of daily living,and reduce the complications.

关 键 词：重症肌无力 机械通气 早期主动活动 基本日常生活能力 

分 类 号：R473.5[医药卫生—护理学]