eCASH理念下早期康复护理对ICU重症肺炎机械通气患者预后的影响  

Effect of Early Rehabilitation Nursing on Prognosis of ICU Patients with Severe Pneumonia with Mechanical Ventilation

作　　者：柯秋亭 郜萍 李阿美 KE Qiuting;GAO Ping;LI Amei(The Second Affiliated Hospital of Xiamen Medical College,Xiamen 361000,China)

机构地区：[1]厦门医学院附属第二医院,福建厦门361000

出　　处：《中国医药指南》2023年第23期161-164,共4页Guide of China Medicine

摘　　要：目的探讨对ICU重症肺炎机械通气患者实施以患者为中心的舒适化浅镇静策略(e CASH)理念下早期康复护理对预后的影响。方法纳入我院2022年1~12月收治的64例ICU重症肺炎机械通气患者,随机进行分组,各32例,对照组予以ICU常规护理,观察组基于对照组予以e CASH理念下早期康复护理,详细统计两组机械通气时间、入住ICU时间,应用舒适状况量表(GCQ)评估两组脱机时舒适度,应用ICU急性生理及慢性健康状况评分Ⅱ(APACHEⅡ)评估两组预后效果,监测两组干预前后动脉血气分析指标,观察两组干预前后T淋巴细胞亚群变化,对比并发症发生率。结果比较对照组,观察组机械通气时间、入住ICU时间更短,GCQ评分更高,APACHEⅡ评分更低(P<0.05);比较对照组,干预后,观察组PaO_(2)水平更高,PaCO_(2)、NT-proBNP水平更低(P<0.05);比较对照组,干预后,观察组CD4^(+)、CD4^(+)/CD8^(+)水平更高,CD8^(+)水平更低(P<0.05);比较对照组,观察组并发症发生率更低(P<0.05)。结论对ICU重症肺炎机械通气患者实施以患者为中心的eCASH理念下早期康复护理的效果显著,可强化机体免疫功能,改善动脉血气,继而缓解肺部通气状况,进一步缩短机械通气时间,最大限度地避免并发症的发生,加速病情康复速度,提高预后效果。Objective To investigate the effect of early rehabilitation nursing on prognosis of ICU patients with severe pneumonia mechanical ventilation with the concept of patient-centered comfortable shallow sedation strategy(eCASH).Methods Sixty-four mechanical ventilation patients with severe pneumonia in ICU were included in our hospital from January 2022 to December 2022,and they were randomly divided into 32 patients in each group.The control group was given routine ICU nursing,while the observation group was given early rehabilitation nursing based on the eCASH concept of the control group.The mechanical ventilation time and ICU stay time of the two groups were analyzed in detail.The General Comfort Questionnaire(GCQ)was used to evaluate the off-line comfort of the two groups.ICU acute physiology and chronic health evaluationⅡ(APACHEⅡ)was used to evaluate the prognosis of the two groups.Arterial blood gas indexes of the two groups were monitored before and after intervention,and changes in T lymphocyte subsets of the two groups were observed before and after intervention.Results Compared with control group,mechanical ventilation time and ICU stay time in observation group were shorter,GCQ score was higher,APACHEⅡscore was lower(P<0.05).Compared with the control group,after intervention,the level of PaO_(2)in the observation group was higher,the level of PaCO_(2)and NT-proBNP was lower(P<0.05).Compared with the control group,after intervention,the level of CD4^(+),CD4^(+)/CD8^(+)in the observation group was higher,and the level of CD8^(+)was lower(P<0.05).Compared with the control group,the complication rate in the observation group was lower(P<0.05).Conclusion The implementation of the patient-centered eCASH for mechanical ventilation patients with severe pneumonia in ICU has significant effect on early rehabilitation nursing,which can strengthen the immune function of the body,improve arterial blood gas,and then relieve lung ventilation conditions,further shorten the time of mechanical ventilation,avoid compl

关 键 词：ICU重症肺炎 机械通气 舒适化浅镇静策略 早期康复护理 免疫功能 动脉血气 预后 

分 类 号：R563[医药卫生—呼吸系统] R473.5[医药卫生—内科学]