摘要
目的:探讨ABCDEF(觉醒与自主呼吸试验、呼吸功能锻炼、脑神经康复、血糖监测、早期活动和锻炼、家属参与、授权)干预措施在预防麻醉复苏加强监护室机械通气患者发生ICU获得性衰弱的方法及效果。方法:选取东部战区总医院2017年6月至2018年5月麻醉科符合纳入标准的160例患者作为试验组,给予ABCDEF干预措施;选取东部战区总医院2016年6月至2017年5月麻醉科符合纳入标准的160例患者作为对照组,接受常规干预措施。比较两组第4,7,10天发生ICU获得性衰弱、肌肉骨骼肌成分分析情况,比较两组呼吸机相关性肺炎(ventilator associated pneumonia,VAP)、机械通气时间、加强监护室住院时间的情况。结果:第4,7,10天试验组发生ICU获得性衰弱的比例低于对照组,肌体肌肉总量及骨骼肌含量高于对照组(P<0.05);第4,7,10天试验组VAP的发生率、机械通气的时间、加强监护室住院时间明显低于对照组(P<0.05)。结论:ABCDEF干预措施能有效降低麻醉复苏加强监护室机械通气患者ICU获得性衰弱和VAP的发生率,增加患者肌肉总量及骨骼肌含量,减少呼吸机的使用时间,提高患者的生存质量。
Objective: To explore the methods and effectiveness of ABCDEF intervention care in prevention of ICU-acquired weakness (ICU-AW) in anesthesia intensive care unit (AICU). Methods: One hundred and sixty patients from June 2016 to May 2017 were given routine care, 160 patients from Jun 2017 to May 2018 were given ABCDEF intervention care. Medical Research Council (MRC) score was measured at 4th, 7th and 10th day after mechanical ventilation. The occurrence of ICU-AW and ventilator associated pneumonia (VAP), musculoskeletal muscle component, length of mechanical ventilation and length of stay were recorded. Results: The MRC-scores in the experimental group were significantly higher than that in the control group (P<0.05). Significant improvements in the occurrence of ICU-AW and VAP, musculoskeletal muscle component, length of mechanical ventilation and length of stay were also demonstrated in the experimental group (P<0.05). Conclusion: ABCDEF intervention care can prevent the occurrence of ICU-AW and VAP, increase musculoskeletal muscle component and decrease length of mechanical ventilation, finally improve the quality of life.
作者
张林香
孙丽
周达梅
方小燕
ZHANG Linxiang;SUN Li;ZHOU Damei;FANG Xiaoyan(Department of Anaesthesiology, General Hospital of Eastern Theater Command, Nanjing 210002, China)
出处
《临床与病理杂志》
2019年第6期1260-1265,共6页
Journal of Clinical and Pathological Research
关键词
干预
麻醉恢复室
加强监护室
ICU获得性衰弱
机械通气
intervention
post-anesthesia care unit
anesthesia intensive care unit
ICU-acquired weakness
mechanical ventilation
