摘要
目的探讨早期康复策略应用于危重症机械通气患者对认知功能、肌肉功能和谵妄、获得性肌无力的影响。方法选取2021年1至2022年12月在某三级甲等医院急诊ICU收治的80例危重症机械通气患者为研究对象,随机分为试验组和对照组,每组40例。对照组在常规治疗护理的基础上采用ABCDEF集束化的康复方案,试验组在常规治疗护理的基础上采用早期康复策略,比较两组在肌肉功能、认知功能和谵妄、获得性肌无力、营养状态、机械通气时间和住院时间的差异。结果拔管后第1天和转出ICU前,两组患者的MMSE比较差异均无统计学意义(P>0.05);但转出ICU后或出院的第7天、1个月、3个月、6个月,试验组的MMSE均显著高于对照组,差异有统计学意义(P<0.05)。试验组的肌肉功能和营养状况显著高于对照组。试验组谵妄和ICU获得性肌无力的发生率及机械通气时间、ICU住院时间、总住院时间显著低于对照组,差异均有统计学意义(P<0.05)。结论危重症机械通气患者应用早期康复策略干预,可改善肌肉功能和认知功能,减少谵妄和ICU获得性肌无力的发生,缩短机械通气时间、ICU住院时间和总住院时间,从而改善疾病的长期预后。
Objective To explore the effect of early rehabilitation strategy on cognitive function,muscle function,delirium and acquired muscle weakness in critically ill patients with mechanical ventilation.Methods A total of 80 critically ill patients with mechanical ventilation who were admitted to the emergency ICU of a hospital from January to December 2021 were selected as the study subjects.They were randomly divided into the experimental group and the control group.The control group adopted the ABCDEF cluster rehabilitation scheme on the basis of routine treatment and nursing.The experimental group adopted the early rehabilitation strategy on the basis of routine treatment and nursing,and compared the two groups in terms of muscle function,cognitive function,delirium,acquired myasthenia differences in nutritional status,mechanical ventilation time and hospital stay.Results There was no significant difference in MMSE between the two groups on the first day after extubation and before transfer from ICU(P>0.05).However,the MMSE of the experimental group was significantly higher than that of the control group on the 7th day,1st month,3rd month and 6th month after transfer out of ICU or discharge(P<0.05).The muscle function and nutritional status of the experimental group were significantly higher than that of the control group.The incidence of delirium and ICU acquired myasthenia,mechanical ventilation time,ICU hospitalization time and total hospitalization time in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion Early rehabilitation intervention can improve muscle function and cognitive function,reduce delirium and ICU acquired muscle weakness,shorten mechanical ventilation time,ICU hospitalization time and total hospitalization time,and improve the long-term prognosis of the disease.
作者
谭春苗
邱育研
陈淼
林兴华
TAN Chunmiao;QIU Yuyan;CHEN Miao;LIN Xinghua(Department of Geriatrics,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Emergency ICU,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China;Department of Emergency,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)
出处
《中国老年保健医学》
2023年第4期142-146,共5页
Chinese Journal of Geriatric Care
基金
海南医学院第一附属医院青年培育基金项目(编号:HYYFYPY202123)
海南省卫生健康行业科研项目(编号:20A200371)。
关键词
机械通气
老年人
早期康复
预后
危重症
mechanical ventilation
elderly
early rehabilitation
prognosis
critical illness
