基于目标策略的进阶式康复护理对重症肺炎伴呼吸衰竭机械通气患者康复效果的影响  

Effect of target strategy-based advanced pulmonary rehabilitation nursing on the rehabilitation effect in severe pneumonia patients requiring mechanical ventilation due to respiratory failure

作　　者：张娟[1] 张会民[1] 丁密[1] 周晓蕾[1] 傅自茹 兰云霞[1] ZHANG Juan;ZHANG Huimin;DING Mi;ZHOU Xiaolei;FU Ziru;LAN Yunxia(Department of Respiratory Medicine,Henan Provincial Chest Hospital,Zhengzhou 450008,Henan Province,China)

机构地区：[1]河南省胸科医院呼吸内科,河南郑州450008

出　　处：《新乡医学院学报》2025年第5期420-425,共6页Journal of Xinxiang Medical University

基　　金：2022年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20220239);2023年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20230122)。

摘　　要：目的探讨目标策略性进阶式康复护理对重症肺炎合并呼吸衰竭机械通气患者康复的影响。方法选择2021年3月至2023年2月河南省胸科医院诊治的86例重症肺炎合并呼吸衰竭患者为研究对象,按护理方法不同将患者分为对照组和观察组,每组43例。对照组患者在机械通气过程中接受常规康复护理,观察组患者采用基于目标策略的进阶式康复护理。2组患者均在转出重症监护病房(ICU)时评价干预效果。比较2组患者的机械通气时间、ICU住院时间、氧合指数(OI)、浅快呼吸指数(RSBI)、第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)、最大呼气流速(PEFR)、第1秒用力呼气容积(FEV_(1))/用力肺活量(FVC)及并发症。结果观察组患者的机械通气时间、ICU住院时间均显著短于对照组(P<0.05)。干预前,2组患者的OI、RSBI值比较差异无统计学意义(P>0.05);干预后,2组患者的OI值显著高于对照组,RSBI值显著低于干预前(P<0.05);干预后,观察组患者的OI值显著高于对照组,RSBI显著低于对照组(P<0.05)。干预前,2组患者的FEV_(1)%pred、PEFR、FEV_(1)/FVC比较差异无统计学意义(P>0.05);干预后,2组患者的FEV_(1)%pred、PEFR、FEV_(1)/FVC显著高于干预前,且观察组患者的FEV_(1)%pred、PEFR、FEV_(1)/FVC显著高于对照组(P<0.05)。观察组ICU获得性衰弱患者显著少于对照组(P<0.05);2组患者误吸、谵妄、压力性损伤及深静脉血栓形成发生率比较差异无统计学意义(P>0.05)。结论基于目标策略的进阶式康复护理能显著缩短重症肺炎合并呼吸衰竭患者机械通气时间和住院时间,促进肺功能恢复,降低ICU获得性衰弱风险。Objective To explore the impact of target strategy-based advanced pulmonary rehabilitation nursing on the rehabilitation effect of severe pneumonia patients requiring mechanical ventilation due to respiratory failure.Methods A total of 86 severe pneumonia patients with respiratory failure diagnosed and treated at Henan Provincial Chest Hospital from March 2021 to February 2023 were included.They were randomly divided into a control and an observation group according to the nursing method used,with 43 cases in each group.Patients in the control group received routine pulmonary rehabilitation care during mechanical ventilation,while those in the observation group received target strategy-based advanced pulmonary rehabilitation care.The intervention effect in both groups of patients was evaluated when they were transferred out of the intensive care unit(ICU).The mechanical ventilation time,ICU hospitalization time,oxygenation index(OI),rapid shallow breath index(RSBI),forced expiratory volume at second 1(FEV 1%pred),peak expiratory flow rate(PEFR),FEV 1/forced vital capacity(FVC),and complications were compared between the two groups.Results The mechanical ventilation time and ICU hospitalization time in the observation group were shorter than those in the control group(P<0.05).The OI and RSBI values were not significantly different between the two groups before intervention(P>0.05).In both groups,the OI values significantly increased while the RSBI values significantly decreased after intervention(P<0.05).After intervention,the observation group had a higher OI value and a lower RSBI value than those in the control group(P<0.05).There was no significant difference in FEV 1%pred,PEFR and FEV 1/FVC between the two groups before intervention(P>0.05).The FEV 1%pred,PEFR and FEV 1/FVC values after intervention were significantly higher than those before intervention in both groups(P<0.05).The FEV 1%pred,PEFR and FEV 1/FVC values in the observation group were significantly higher than those in the control group after int

关 键 词：重症肺炎 呼吸衰竭 机械通气 目标策略 进阶式肺康复护理 

分 类 号：R473.5[医药卫生—护理学]