基于eCASH理念的肺康复训练在AECOPD合并Ⅱ型呼吸衰竭患者中的应用  

Application of pulmonary rehabilitation training based on the eCASH concept in patients with AECOPD combined with type Ⅱ respiratory failure

作　　者：杨建兰 王昕慧 沈燕 梅洁 沈怡卿 颜慰安 YANG Jianlan;WANG Xinhui;SHEN Yan;MEI Jie;SHEN Yiqing;YAN Wei'an(Suzhou Municipal Hospital,Nanjing 215000,China)

机构地区：[1]苏州巿立医院北区/南京医科大学附属苏州医院重症医学科,江苏省南京市215000

出　　处：《护理实践与研究》2024年第11期1694-1699,共6页Nursing Practice and Research

基　　金：苏州市立医院护理科研究项目(编号:Slyyhl202209)。

摘　　要：目的探讨基于以患者为中心的舒适化浅镇静(eCASH)理念下的肺康复训练在机械通气慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭(RF)患者中的应用。方法选取2021年1月—2023年1月苏州巿立医院重症医学科收治的AECOPD合并Ⅱ型RF患者110例为研究对象,按照组间基线资料具有可比性原则将入组患者分为对照组和观察组,对照组55例患者基于常规镇静镇痛下实施肺康复训练,观察组患者基于eCASH理念下行肺康复训练。比较两组患者康复进程、镇痛与镇静效果、不良事件发生情况。结果干预后,观察组患者机械通气、开展肺功能康复训练以及住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组重症监护室疼痛观察工具评分低于对照组,镇静达标时间、停药后清醒时间均短于对照组,差异有统计学意义(P<0.05)。观察组患者不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论基于eCASH理念的肺康复训练在行机械通气AECOPD合并Ⅱ型RF患者中应用,能够发挥良好的镇痛、镇静效果,为肺康复训练提供条件,继而有效促进患者康复进程,减少相关不良事件的发生。Objective To explore the application of pulmonary rehabilitation training based on the early comfort using analgesia,minimal sedatives and maximal humane care(eCASH)concept in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with type Ⅱ respiratory failure(RF).Methods To select 110 patients with AECOPD and type Ⅱ RF admitted to the Department of Critical Care Medicine of Suzhou Municipal Hospital from January 2021 to January 2023 as the research subjects.According to the principle of comparability of baseline data between the groups,the included patients were divided into a control group and an observation group.Among them,55 patients in the control group received pulmonary rehabilitation training under conventional sedation and analgesia,and the observation group received pulmonary rehabilitation training based on the eCASH concept.The recovery process,analgesic and sedative effects,and adverse events were compared between the two groups.Results After intervention,the duration of mechanical ventilation,pulmonary function rehabilitation training and hospitalization of the observation group were shorter than those of the control group,the differences were statistically significant(P<0.05).The intensive care unit pain observation tool score of the observation group was lower than that of the control group,and the sedation compliance time and awakening time after drug withdrawal were shorter than those of the control group,the differences were statistically significant(P<0.05).The incidence of adverse events of patients in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The application of pulmonary rehabilitation training based on the eCASH concept in mechanically ventilated AECOPD patients with type Ⅱ RF can exert good analgesic and sedative effects,provide conditions for pulmonary rehabilitation training,and then effectively promote the patient's rehabilitation process and reduce the occurr

关 键 词：慢性阻塞性肺疾病急性加重期 Ⅱ型呼吸衰竭 机械通气 舒适化浅镇静策略理念 肺康复训练 

分 类 号：R473.56[医药卫生—护理学]