早期目标导向活动对机械通气患者短期预后的应用研究  

The application of early goal-directed mobilization to the short-term prognosis of patients with mechanical ventilation

作　　者：李桂芳[1] 贾雪萍 杨红晓[1] 张桂珍[1] 王亮[1] 王金聪 杨星雨 LI Guifang;JIA Xueping;YANG Hongxiao;ZHANG Guizhen;WANG Liang;WANG Jincong;YANG Xingyu(Intensive Care Unit,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Medical Care,Alxa Vocational and Technical College,Alxa Left Banner 750300,China;Nursing School,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院ICU,宁夏银川750004 [2]阿拉善职业技术学院医护系,内蒙古阿拉善盟750300 [3]宁夏医科大学护理学院,宁夏银川750004

出　　处：《宁夏医学杂志》2024年第3期222-225,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2022AAC03513)。

摘　　要：目的探讨早期目标导向活动在重症加强护理病房(ICU)机械通气患者中应用的短期预后效果。方法采用便利抽样法,选取76例机械通气患者作为研究对象,以病区为单位,入住ICU A区的38例患者为对照组,实施常规康复护理方案;入住ICU B区的38例患者为实验组,采用Richmond躁动-镇静评分、标准化5问题问卷、ICU活动量表评估研究对象镇静程度、配合程度及ICU活动能力,实施早期目标导向活动。观察2组患者肌力及握力水平、ICU活动能力、机械通气时间及ICU住院时间。结果干预第4 d及出科前实验组肌力、握力及出科前的活动能力得分高于对照组(P<0.05);实验组机械通气时间及ICU住院时间短于对照组(P<0.05)。结论早期目标导向活动有助于提高机械通气患者的肌力、活动能力,缩短ICU停留时间,改善患者短期预后。未来可进一步随访,探究早期目标导向活动的远期效果,为早期目标导向活动的推广及应用提供临床指导。Objective To investigate the effect of early goal-directed mobilization on short-term prognosis of patients with mechanical ventilation in ICU.Methods Convenience sampling method was used to select 76 patients with mechanical ventilation who were admitted to the ICU of A Grade A tertiary hospital as the study objects,and 38 patients in ward A as the control group.Routine rehabilitation nursing program was implemented.38 patients admitted to ICU area B were the experimental group.Richmond agitation and sedation scale,standardized five questions,ICU mobility scale was used to evaluate the sedation degree,cooperation degree and ICU activity ability of the study subjects,and early goal-directed mobilization were implemented.Muscle strength and grip strength levels,physical activity in the ICU,mechanical ventilation time and length of stay in ICU were observed in two groups.Results The score of muscle strength,grip strength and activity ability of the experimental group were higher than those of the control group on the 4th day of intervention and before discharge(P<0.05).The mechanical ventilation time and length of stay in ICU of the experimental group were lower than those of the control group(P<0.05).Conclusion Early goal directed mobilization can improve the muscle strength and mobility of patients with mechanical ventilation in ICU,shorten the length of stay in ICU,and improve the short-term prognosis of patients.Further follow-up can be conducted in the future to explore the long-term effects of early goal-oriented activities and provide clinical guidance for the promotion and application of early goal directed mobilization.

关 键 词：目标导向理论 早期活动 重症加强护理病房 机械通气 短期预后 肌力 

分 类 号：R473[医药卫生—护理学]