摘要
目的探讨床上脚踏车联合上肢被动关节活动在急性呼吸衰竭机械通气患者中的应用效果.方法采用便利抽样法选取2017年4月-2018年1月入住中国科学院大学宁波华美医院ICU急性呼吸衰竭机械通气患者94例,随机分为干预组和对照组.对照组行ICU常规特级护理和活动干预;干预组在此基础上给予双下肢床上脚踏车联合上肢被动关节活动干预.比较两组患者干预效果.最终共90例患者完成研究,干预组44例,对照组46例.结果干预组患者的机械通气时间、ICU住院时间、ICU获得性衰弱发生率均低于对照组,干预组患者在早期活动第7天潮气量高于对照组,二氧化碳分压和呼吸频率低于对照组,转出ICU时Barthel指数评分高于对照组,差异均具有统计学意义(P<0.05).两组患者均未发生严重不良事件.结论对于急性呼吸衰竭机械通气患者,床上脚踏车联合上肢被动关节活动安全可行,能降低患者的机械通气时间、ICU住院时间和ICU获得性衰弱发生率,提高患者生活自理能力.
Objective To explore the effect of bed-mounted bicycle combined with passive joint movement of upper extremities in patients with acute respiratory failure undergoing mechanical ventilation. Methods Totally 94 patients with acute respiratory failure undergoing mechanical ventilation from intensive care unit (ICU) in Hwa Mei Hospital were selected by convenient sampling and randomly divided into the intervention group and the control group from April 2017 to January 2018. The control group received routine intensive care and activity intervention. On this basis, the intervention group received lower extremities bed-mounted bicycles combined with the upper extremities passive joint movement. The intervention effect of the two groups were compared. At last,a total of 90 patients completed the study, with 44 in intervention group and 46 in control group. Results Mechanical ventilation duration, ICU stay time, and incidence of ICU acquired weakness (ICU-AW) were less in the intervention group than in the control group (P<0.05). At the seventh day of taking activity intervention, the tidal volume of intervention group was higher than control group (P<0.05);the partial pressure of carbon dioxide and respiratory rate of intervention group were lower than control group (P<0.05). When transferred out of ICU, the Barthel Index scores were higher in intervention group (P<0.05). In addition, there was no serious adverse effect in both groups. Conclusions Bed-mounted bicycle combined with passive joint movement of upper extremities in patients with acute respiratory failure undergoing mechanical ventilation was safe and feasible. It can reduce the duration of mechanical ventilation, ICU stay time, and the incidence of ICU-AW, as well as improve patients' self-care ability.
作者
虞立
姜金霞
Yu Li;Jiang Jinxia(Intensive Care Unit,Hwa Mei Hospital,University of Chinese Academy of Sciences,Ningbo 315010,China;Department of Emergency,Tenth People Hospital of Tongji University,Shanghai 200072,China)
出处
《中华现代护理杂志》
2019年第21期2734-2738,共5页
Chinese Journal of Modern Nursing
关键词
呼吸
人工
呼吸功能不全
康复护理
脚踏车
被动关节活动
Respiration,artificial
Respiratory insufficiency
Rehabilitation nursing
Bed-mounted bicycle
Passive joint movement of the upper extremities
