基于量化评估早期四级康复训练在ICU机械通气患者护理中的应用  

Application of early four-stage rehabilitation training based on quantitative evaluation in ICU mechanical ventilation patients

作　　者：周宁 宋淑玲[1] 高娜 刘超[3] 郭文 刘翠平 李晶[1] 周超 Zhou Ning;Song Shuling;Gao Na;Liu Chao;Guo Wen;Liu Cuiping;Li Jing;Zhou Chao(Department of Intensive Care Medicine,Binzhou Central Hospital,251700,China;Interventional Treatment Room,Binzhou Central Hospital,251700,China;Department of Bone and Spine Surgery,Binzhou Central Hospital,251700,China;Department of Spine Surgery,Qilu Hospital of Shandong University(Qingdao),Qingdao,266035,China)

机构地区：[1]滨州市中心医院重症医学科,251700 [2]滨州市中心医院介入治疗室,251700 [3]滨州市中心医院骨脊柱外科,251700 [4]山东大学齐鲁医院(青岛)脊柱外科,青岛266035

出　　处：《国际护理学杂志》2023年第4期655-660,共6页international journal of nursing

摘　　要：目的探究基于量化评估早期四级康复训练对ICU机械通气患者神经肌肉功能、肺功能及并发症的影响。方法选取2020年1月至2021年5月滨州市中心医院ICU收治的120例机械通气患者为研究对象,按照两组资料具有匹配性的原则平均分为两组,对照组60例患者住院期间进行常规护理干预,试验组60例患者在对照组基础上基于量化评估进行早期四级康复训练,选用功能独立性评价量表(FIM)评估患者干预前后神经肌肉功能的改善情况,检测患者肺功能指标,记录患者并发症发生情况。结果干预前两组患者FIM各维度评分、用力肺活量(FVC)和第1秒用力呼气体积与FVC的比值(FEV_(1)/FVC)水平相比较组间差异均无统计学意义(P>0.05);干预后试验组患者FIM各维度评分、FVC、和FEV_(1)/FVC水平均明显高于对照组,组间差异有统计学意义(P<0.05);试验组患者并发症〔呼吸机相关性肺炎(VAP)、压力性损伤、DVT和ICU-AW〕发生率明显低于对照组,组间差异有统计学意义(P<0.05)。结论基于量化评估对ICU机械通气患者进行早期四级康复训练,可有效促进神经肌肉功能的恢复,改善患者肺功能,还能够减少相关并发症的发生。Objective To explore the effects of quantitative evaluation of early four-stage rehabilitation training on neuromuscular function,lung function and complications in patients with mechanical ventilation in ICU.Methods A total of 120 patients with mechanical ventilation admitted to ICU of the hospital from January 2020 to May 2021 were selected as the study objects,and were evenly divided into two groups according to the principle of matching data between the two groups.Sixty patients in the control group received routine nursing intervention during hospitalization,and sixty patients in the experimental group received early four-stage rehabilitation training based on quantitative evaluation on the basis of the control group.Functional Independence Assessment Scale(FIM)was used to evaluate the improvement of neuromuscular function before and after intervention,to detect the pulmonary function indexes of patients,and to record the occurrence of complications.Results Before intervention,there were no significant differences in FIM scores,forced vital capacity(FVC)and forced vital capacity rate of one second/FVC(FEV_(1)/FVC)levels between the two groups(P>0.05).After intervention,FIM scores of all dimensions、the levels of FVC and FEV_(1)/FVC in experimental group were significantly higher than those in control group,and the differences were statistically significant(P<0.05).The incidence of complications〔ventilator-associated pneumonia(VAP),pressure sores,deep venous thrombosis(DVT)and ICU-acquired myasthenia(ICU-AW)〕of the experimental group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusions Early four-stage rehabilitation training based on quantitative evaluation for patients with mechanical ventilation in ICU can effectively promote the recovery of neuromuscular function,improve the lung function of patients,and reduce the occurrence of related complications.

关 键 词：ICU机械通气 量化评估 早期四级康复训练 神经肌肉功能 肺功能 

分 类 号：R472.2[医药卫生—急诊医学]