基于早期活动筛选标准评估的早期活动对危重症患儿康复的影响  

Effect of early mobilization evaluated by related protocols on critically ill children′s rehabilitation

作　　者：王玉 赵丽 蔡榕[1] WANG Yu;ZHAO Li;CAI Rong(Department of Emergency Medicine,Children′s Hospital Affiliated to Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属儿童医院急诊医学科,江苏南京210000

出　　处：《皖南医学院学报》2023年第3期300-304,共5页Journal of Wannan Medical College

基　　金：南京市卫生科技发展专项基金项目(JQX21008)。

摘　　要：目的:探讨基于早期活动筛选标准评估的早期活动对危重症患儿康复的影响。方法:选取2020年8月~2021年9月入住PICU的80例重症患儿为研究对象,将2021年2月及以前入住的40例患儿设为对照组,之后入住的40例患儿为干预组。对照组患儿进行常规活动,干预组患儿根据疾病分期,实施早期活动。收集干预组患儿踩脚踏车式活动前后5 min生命体征变化情况,比较两组患儿六级肌力评定(MRC)评分、能力低下儿童评定量表(PEDI)评分、机械通气时间、PICU留住时间等。结果:干预组25例(65.79%)患儿完成康复期早期活动,除舒张压活动前后差异有统计学意义(P<0.05),其他生命体征变化差异没有统计学意义(P>0.05);干预组内完成踩脚踏车式活动的患儿活动后MRC评分高于活动前评分(P<0.05);未进行活动的患儿自理能力、移动、社会功能出科时的分数均低于入科时(P<0.05);对照组出科时MRC评分较入科时降低(P<0.05),而干预组入科时与出科时MRC评分变化差异无统计学意义(P>0.05);两组干预前后不同时期之间PEDI评分差异有统计学意义(P<0.05),干预时间与干预方式之间存在交互效应(P<0.05);干预后干预组机械通气时间、PICU留住时间、住院时间均低于对照组(P<0.05)。结论:基于早期活动筛选标准评估的早期活动可提高患儿肌力和日常活动能力,缩短机械通气时间和ICU留住时间。Objective:To investigate the effect of early mobilization evaluated by related protocols on critically ill children′s rehabilitation.Methods:Eighty critically ill children,admitted to PICU between August 2020 and September 2021,were included in current study.Forty children admitted in February 2021 and before were enrolled in control group,and another 40 after February 2021 were enrolled in intervention group.The children in the control group underwent routine rehabilitation training.Those in the intervention group received early mobilization according to their disease stage.Vital signs of children in intervention group were recorded 5 minutes before and after in-bed cycling activity.Comparison was made in Medical Research Council(MRC)score,Pediatric Evaluation of Disability Inventory(PEDI)score,duration of mechanical ventilation,length of PICU stay between two groups.Results:In the intervention group,25 children(65.79%)completed early mobilization during rehabilitation phase.The difference of diastolic blood pressure before and after the activity was statistically significant(P<0.05).However,there was no significant difference in other vital signs(P>0.05).The MRC score after the in-bed cycling activity was higher than that before the activity(P<0.05).As for children who didn′t participate in the activity,their PEDI scores of self-care ability,mobility and social function at admission were lower than those at discharge(P<0.05).The MRC score of the control group at discharge was lower than that at admission(P<0.05).However,there was no significant difference between the MRC score of the intervention group at discharge and that at admission(P>0.05).There was significant difference in PEDI scores between two groups at different periods before and after the intervention(P<0.05).An interactive effect was found between intervention time and intervention mode(P<0.05).After the intervention,duration of mechanical ventilation,length of PICU stay and length of hospital stay of the intervention group were lower than tho

关 键 词：危重症患儿 早期活动 机械通气 康复护理 

分 类 号：R473.72[医药卫生—护理学]