早期康复治疗对机械通气患者ICU获得性肌无力的影响  

Effect of early rehabilitation on ICU acquired weakness in patients with mechanical ventilation

作　　者：蔡雪[1] 庄雯雯[1] 展思东[1] CAI Xue;ZHUANG Wen-wen;ZHAN Si-dong(Huizhou Central People's Hospital,Huizhou 516000,China)

机构地区：[1]广东省惠州市中心人民医院,516000

出　　处：《中国实用医药》2023年第7期148-151,共4页China Practical Medicine

摘　　要：目的探讨早期康复治疗对机械通气患者重症加强护理病房(ICU)获得性肌无力的影响。方法100例ICU获得性肌无力机械通气患者为研究对象,随机分为治疗组与对照组,各50例。对照组采用常规ICU治疗,治疗组在对照组基础上采用早期康复治疗。对比两组ICU停留时间、机械通气时间、住院28 d死亡情况及干预前后肌肉参数变化情况。结果治疗组ICU停留时间(6.41±0.45)d、机械通气时间(5.01±1.03)d均短于对照组的(8.77±0.71)、(6.51±1.99)d,住院28 d死亡率4.00%低于对照组的22.00%,差异有统计学意义(P<0.05)。干预后,两组股直肌横断面积、股直肌厚度、股中间肌厚度、膈肌增厚率、膈肌活动度均优于本组干预前,且治疗组均优于对照组,差异均有统计学意义(P<0.05)。干预后,两组膈肌厚度均优于本组干预前,差异有统计学意义(P<0.05),但组间对比差异无统计学意义(P>0.05)。结论早期康复治疗的应用在改善机械通气患者ICU获得性肌无力方面效果理想,值得推广应用。Objective To discuss the effect of early rehabilitation on intensive care unit(ICU)acquired weakness in patients with mechanical ventilation.Methods A total of 100 cases of mechanically ventilated patients patients with ICU acquired weakness were studied and randomly divided into treatment group and control group,with 50 cases in each group.The control group was treated with conventional ICU care,and the treatment group was treated with early rehabilitation on the basis of the control group.The duration of ICU stay,duration of mechanical ventilation,death at 28 d of hospitalization and changes in muscle parameters before and after intervention were compared between the two groups.Results The treatment group had duration of ICU stay of(6.41±0.45)d and mechanical ventilation of(5.01±1.03)d,which were shorter than those of(8.77±0.71)and(6.51±1.99)d in the control group;the mortality rate at 28 d of hospitalization was 4.00% in the treatment group,which was lower than that of 22.00% in the control group;the differences were statistically significant(P<0.05).After the intervention,the transverse area of the rectus femoris,thickness of the rectus femoris,thickness of the vastus intermedius,rate of diaphragm thickening and activity of diaphragm in both groups were better than those before the intervention in this group,and the treatment group was better than the control group.The differences were statistically significant(P<0.05).After the intervention,the rate of diaphragm thickening in the two groups were better than that before the intervention in this group,and the difference was statistically significant(P<0.05),but there was no statistically significant between the two groups(P>0.05).Conclusion Application of early rehabilitation has ideal effect in improving ICU acquired weakness in patients with mechanical ventilation,and is worthy of popularization and application.

关 键 词：重症加强护理病房获得性肌无力 机械通气 早期康复治疗 重症超声 

分 类 号：R473[医药卫生—护理学]