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作 者:杨静[1] 黄永鹏[1] 何中华[1] 叶燕红[1] 黎智宾 Yang Jing;Huang Yongpeng;He Zhonghua(The Gaoming People's Hospital of Foshan City,Foshan,Guangdong 528500)
出 处:《基层医学论坛》2023年第9期4-6,14,共4页The Medical Forum
基 金:佛山市卫生健康局2021年度佛山市医学科研立项(20210108)。
摘 要:目的探讨重症监护病房(ICU)重症肺炎机械通气患者采用早期运动联合医护一体化管理的效果。方法采用随机数字表法将佛山市高明区人民医院2021年3—12月收治的ICU重症肺炎机械通气患者68例分为2组各34例,对照组采用常规护理,观察组加用早期运动联合医护一体化管理。统计2组临床指标,比较2组干预前、干预后的病情严重程度[序贯器官衰竭评估(SOFA)评分、急性生理与慢性健康状况评分Ⅱ(APACHEⅡ评分)]、握力及日常生活活动能力,统计2组呼吸机相关肺炎(VAP)、深静脉血栓(DVT)发生情况。结果观察组ICU入住时间、机械通气时间及住院时间均短于对照组,有统计学差异(P<0.05);干预后,2组APACHEⅡ评分、SOFA评分均比干预前低,且观察组比对照组低,有统计学差异(P<0.05);干预后,2组握力、Barthel指数均较治疗前升高,且观察组高于对照组,有统计学差异(P<0.05);观察组干预期间DVT、VAP发生率[2.94%(1/34)、5.88%(2/34)]低于对照组[23.53%(8/34)、26.47%(9/34)],有统计学差异(P<0.05)。结论ICU重症肺炎机械通气患者采用早期运动联合医护一体化管理可减轻病情程度,促进康复,提高日常生活活动能力,降低并发症发生风险。Objective To investigate the effect of early exercise combined with integrated medical and nursing management in intensive care unit(ICU)patients with severe pneumonia with mechanical ventilation.Methods The random number table method was used to divide 68 patients with severe pneumonia mechanical ventilation in our hospital from March 2021 to December 2021 into 2 groups,34 cases in each group.The control group received routine nursing care.Using early exercise combined with integrated medical and nursing management,the clinical indicators of the two groups were counted,and the severity of the disease before and after the intervention was compared between the two groups[Sequential Organ Failure Assessment(SOFA)score,acute physiology and chronic health status score II(APACHE II score)],grip strength and activities of daily living,and the incidence of ventilator-associated pneumonia(VAP)and deep vein thrombosis(DVT)in the two groups was statistically analyzed.Results The ICU stay time,mechanical ventilation time and hospital stay time in the observation group were shorter than those in the control group,with statistical differences(P<0.05).After the intervention,the grip strength and Barthel index of the two groups were higher than those before treatment,and the observation group was higher than the control group,with a statistical difference(P<0.05);the observation group was intervened during the period,the incidence of DVT and VAP[2.94%(1/34),5.88%(2/34)]was lower than that of the control group[23.53%(8/34),26.47%(9/34)],with statistical differences(P<0.05).Conclusion Early exercise combined with integrated medical and nursing management in ICU patients with severe pneumonia with mechanical ventilation can reduce the severity of the disease,promote patient recovery,improve activities of daily living,and reduce the risk of complications.
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