ISSN 2096-7446　CN 10-1655/R
主管：中国科协技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2020, Vol. 1 ›› Issue (6): 500-505.

• 早期康复护理专题 • 上一篇    下一篇

个性化早期活动方案对机械通气患者肌力的影响

姚彦蓉 刘娜 郑栋莲 王艳 米光丽   

  1. 宁夏医科大学总医院肝胆外科

  • 收稿日期:2020-07-26 出版日期:2020-11-10 发布日期:2020-11-27

Influence of personalized early mobilization intervention program on muscle strength of patients with mechanical ventilation

YAO Yanrong, LIU Na , ZHENG Donglian, WANG Yan, MI Guangli   

  • Received:2020-07-26 Online:2020-11-10 Published:2020-11-27

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摘要： [摘要]目的探讨个性化早期活动方 案对机械通气患者肌力的影响。方法选取2018年10月一2019年7月收治于宁夏某三级甲等医院ICU 80例行机械通气的患者为研究对象,按ICU病房分区进行分组,试验组和对照组各40例。试验组实施个性化早期活动方案,对照组实施常规早期活动护理。在不同时间点对患者的英国医学研究委员会肌力评定法评分(Medical Research Counceil , MRC)、ICU获得性衰弱发生情况、巴氏评分、ICU机械通气时间、ICU住院时间等指标进行评价。结果本研究试验组中途退出1例,最终试验组39例、对照组40例。入ICU时两组患者一般资料比较差异无统计学意义(P>0.05);出ICU时MRC评分。机械通气时间和ICU住院时间,两组组内、组间比较差异具有统计学意义(P<0.05);入ICU时、入ICU48 h、出ICU时重复测量方差分析结果显示,MRC评分的时间效应和组间效应差异有统计学意义(P<0.05),且时间与分组存在交互效应(P<0.05);出院时,试验组巴氏评分高于对照组,差异具有统计学意义(P<0.05)。结论早期活动可以有效减缓机械通气患者入ICU 48 h后的肌力下降,降低出ICU时ICU获得性衰弱的发生率。


关键词: 早期活动;时间点, 机械通气, ICU获得性衰弱;肌力

Abstract:

Objective To explore the effect of personalized early mobilization intervention on muscle strength ofpatients with mechanical ventilation at different time points. MethodsFrom October 2018 to July 2019, 80 ICUpatients who received mechanical ventilation at a tertiary hospital in Ningxia were selected and divided into twogroups according to the division of ICU ward. There were 40 patients in the intervention group and 40 patients inthe control group. The intervention group was given personalized early mobilization intervention , while the controlgroup received ICU routine early mobilization nursing. The general data of the patients, the Medical Research Council (MRC) Score , the incidence of ICU acquired weakness , B arthel Index,ICU mechanical ventilation time,length of ICU stay and other indicators were evaluated at different time points. R esultsOne case in the intervention group declined the study,39 cases finished the study in the intervention group and 40 cases in the controlgroup. There was no significant difference in general data between the two groups when entering ICU , but therewere significant differences in M RC score , incidence of ICU acquired weakness , mechanical ventilation time and length of ICU stay within the group and between the two groups. The results of repeated measures analysis of variance showed that there were significant differences in time effct and inter-group effect for MRC score, and therewere interactive effcts between time and grouping (P<0.05). The Barthel Index of the intervention group was significantly higher than that of the control group when patients were discharged( P<0.05 ). Conclusion Early mobilization intervention can effectively slow down the decrease of muscle strength of mechanically ventilated patients 48 hafter entering ICU and reduce the incidence of ICU acquired weakness when leaving ICU.

Key words: Early Mobilization Intervention, Time Points, Mechanical Ventilation, ICU Acquired W eakness; Muscle Strength