基于4E模式的早期康复干预在ICU机械通气患者中的应用价值  

Application value of early rehabilitation intervention based on 4E model in patients with mechanical ventilation in ICU

作　　者：彭思芹 俞荷花 蒋卓娟 PENG Siqin;YU Hehua;JIANG Zhuojuan(The Second Affi liated Hospital of Naval Medical University,Shanghai,200001,China)

机构地区：[1]海军军医大学第二附属医院,上海市200001

出　　处：《护理实践与研究》2023年第4期565-569,共5页Nursing Practice and Research

摘　　要：目的 探讨基于4E模式的早期康复干预在重症监护室(ICU)机械通气患者中的应用价值。方法 按照组间基本资料具有可比性的原则将2020年1—12月医院收治的86例ICU机械通气患者分为对照组和观察组,每组43例。对照组采用常规护理,观察组采用基于4E模式的早期康复干预。观察两组患者预后情况、肌力水平、Barthel评分、ICU谵妄发生率、ICU谵妄持续时间以及ICU获得性衰弱(ICU-AW)发生率。结果 观察组患者机械通气、ICU住院时间及总住院时间均比对照组短,差异具有统计学意义(P<0.05)。干预前,两组患者肌力评分以及Barthel评分比较差异无统计学意义(P>0.05);干预后,观察组肌力评分和Barthel评分高于对照组,差异有统计学意义(P<0.05)。观察组ICU谵妄发生率、ICU-AW发生率均低于对照组,观察组ICU谵妄持续时间短于对照组,差异具有统计学意义(P<0.05)。结论 基于4E模式的早期康复干预可促进ICU机械通气患者的康复,改善患者肌力程度和日常生活能力,降低ICU-AW和谵妄发生率,减少ICU住院时间、谵妄持续时间。Objective To study the application value of early rehabilitation intervention based on 4E model in patients with mechanical ventilation in intensive care unit(ICU).Methods To 86 patients with mechanical ventilation in ICU admitted by the hospital from January to December 2020 were divided into a control group and an observation group,with 43 patients in each group according to the principle of comparability of basic data between groups.The control group used routine nursing,and the observation group used early rehabilitation intervention based on 4E model.The prognosis,muscle strength,Barthel score,the incidence of delirium in ICU,the duration of delirium in ICU and the incidence of ICU-acquired weakness(ICU-AW) were observed.Results The duration of mechanical ventilation,ICU hospitalization and total hospitalization in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before intervention,there was no significant difference in the muscle strength score and Barthel score between the two groups(P>0.05).After intervention,the muscle strength score and Barthel score in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of delirium in ICU and ICU-AW in the observation group were lower than those in the control group,and the duration of delirium in ICU was shorter than that in the control group,the differences were statistically significant(P<0.05).Conclusion Early rehabilitation intervention based on 4E model can promote the rehabilitation of patients with mechanical ventilation in ICU,improve their muscle strength and ability of daily living,reduce the incidence of ICU-AW and delirium,and reduce the duration of hospitalization and delirium in ICU.

关 键 词：4E模式 早期康复 重症监护室 机械通气 谵妄 肌力水平 日常生活能力 

分 类 号：R473.5[医药卫生—护理学]