早期康复干预在冠脉搭桥术后患者强化胰岛素治疗期间的效果及对预防ICU获得性衰弱的作用  

Effect of Early Rehabilitation Nursing During Intensive Insulin Therapy in Patients After Coronary Artery Bypass Grafting and its Effect on Preventing ICU Acquired Weakness

作　　者：陈战营 孟凡伟 吴娜 齐炳文 史丹卿 权晓强 CHEN Zhanying;MENG Fanwei;WU Na;QI Bingwen;SHI Danqing;QUAN Xiaoqiang(Adult Extracardiac Intensive Care Unit,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451400,Henan,China;Extracorporeal Circulation Department,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451400,Henan,China;Coronary Heart Disease Intensive Care Unit,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451400,Henan,China;Extracardiac Ward 4,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451400,Henan,China)

机构地区：[1]阜外华中心血管病医院成人心外重症监护室,河南郑州451400 [2]阜外华中心血管病医院体外循环科,河南郑州451400 [3]阜外华中心血管病医院冠心病重症监护室,河南郑州451400 [4]阜外华中心血管病医院心外四病区,河南郑州451400

出　　处：《中国药物滥用防治杂志》2024年第11期2056-2059,共4页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20230135)。

摘　　要：目的:探究早期康复干预结合强化胰岛素治疗对预防冠脉搭桥术患者ICU获得性衰弱的作用。方法:选取2023年1月—12月我院接受强化胰岛素治疗的84例冠脉搭桥术患者,依据随机数字表法分为研究组(42例)、参照组(42例)。参照组应用常规干预,研究组应用早期康复干预,对比两组患者肌力评分[医学研究理事会评分(MRC)]、ICU获得性衰弱、胰岛素使用量、血糖水平、抑郁和焦虑情况[医院焦虑抑郁量表(HADS)]、ICU住院时间。结果:干预后,研究组MRC评分高于参照组,差异有统计学意义(P<0.05);研究组ICU获得性衰弱发生率低于参照组,差异有统计学意义(P<0.05);研究组胰岛素使用量低于参照组,差异有统计学意义(P<0.05);两组血糖水平比较,差异无统计学意义(P>0.05);研究组焦虑评分、抑郁评分均低于参照组,差异有统计学意义(P<0.05);研究组机械通气时间、ICU住院时间与总住院时间均低于参照组,差异有统计学意义(P<0.05)。结论:冠脉搭桥术患者在强化胰岛素治疗中配合实施早期康复干预,有助于改善肌力,预防ICU获得性衰弱,减少胰岛素使用量,减轻焦虑和抑郁,缩短治疗时间,干预效果显著。Objective:To explore the effect of early rehabilitation nursing combined with intensive insulin therapy on the prevention of ICU-acquired weakness in patients undergoing coronary artery bypass grafting.Methods:From January 2023 to December 2023,84 patients with coronary artery bypass grafting who received intensive insulin therapy in our hospital were selected and divided into study group(42 patients)and reference group(42 patients)according to the random number table method.The reference group was given routine nursing,and the study group was given early rehabilitation nursing.The muscle strength score[Medical Research Council Score(MRC)],ICU acquired weakness,insulin use,blood glucose level,depression and anxiety[Hospital Anxiety and Depression Scale(HADS)]and ICU hospitalization time were compared between the two groups.Results:After intervention,the MRC score of the study group was higher than that of the reference group,and the difference was statistically significant(P<0.05).The incidence of ICU acquired weakness in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05).The amount of insulin used in the study group was lower than that in the reference group,the difference was statistically significant(P<0.05).There was no significant difference in blood glucose level between the two groups(P>0.05).The anxiety score and depression score of the study group were lower than those of the reference group,and the differences were statistically significant(P<0.05).The mechanical ventilation time,ICU hospitalization time and total hospitalization time of the study group were lower than those of the reference group,and the differences were statistically significant(P<0.05).Conclusion:For patients with coronary artery bypass grafting in intensive insulin therapy,early rehabilitation nursing is help to improve muscle strength,prevention of ICU acquired weakness,reduce insulin use,reduce anxiety and depression,shorten the treatment time,and the nursing effect

关 键 词：早期康复干预 强化胰岛素 冠脉搭桥术 ICU获得性衰弱 肌力 

分 类 号：R654.2[医药卫生—外科学]