脑卒中高龄患者建立人工气道期间行下肢外骨骼机器人康复的护理

doi:10.3761/j.issn.2096-7446.2025.08.012

摘要/Abstract

摘要：

总结1例高龄脑卒中患者建立人工气道期间使用下肢外骨骼机器人行康复训练的护理体会。针对患者高龄、人工气道等康复难题，组建核心团队，促进机器人与危重症康复护理融合；制订科学的机器人康复训练方案，实施可视化监测；全程气道评估管理，保证机器人训练的安全性；动态营养监测，提升机器人康复的耐受性；依托接纳承诺心理疗法，提高机器人训练的依从性。经过180 d的康复和护理，患者恢复良好，双侧肢体肌力、双上肢握力显著提高，双小腿腿围明显增加。

关键词: 人工气道, 脑卒中, 下肢外骨骼机器人, 康复护理

Abstract:

To summarize the nursing care of an elderly stroke patient with artificial airway who underwent rehabilitation training using a lower limb exoskeleton robot. In addressing the rehabilitation challenges posed by the patient’s advanced age and the presence of an artificial airway，a core team was established to integrate robotics with critical care rehabilitation nursing. A scientifically designed robotic rehabilitation training plan was developed，incorporating visual monitoring. Comprehensive airway assessment and management were implemented to ensure the safety of robotic training. Dynamic nutritional monitoring was conducted to enhance the patient’s tolerance to robotic rehabilitation. Psychological interventions based on acceptance and commitment therapy （ACT） were utilized to improve adherence to the robotic training regimen. After 180 days of rehabilitation and nursing，the patient showed significant improvement in bilateral limb muscle strength，upper limb grip strength，and a noticeable increase in calf circumference.

Key words: Artificial Airway, Stroke, Limb Exoskeleton Robot, Rehabilitation Nursing

黄晶, 鲁闻燕, 刘晓玲, 章丹, 张雪梦. 脑卒中高龄患者建立人工气道期间行下肢外骨骼机器人康复的护理[J]. 中华急危重症护理杂志, 2025, 6(8): 967-970.

HUANG Jing, LU Wenyan, LIU Xiaoling, ZHANG Dan, ZHANG Xuemeng. Nursing care for a stroke patient with artificial airway undergoing rehabilitation with lower limb exoskeleton robot[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 967-970.

图/表 1

参考文献 9

[1]	World Stroke Organization. World stroke day 2022[EB/OL]. (2022-10-29) [2024-04-25]. https://www.who.int/srilanka/news/de-tail/29-10-2022-world-stroke-day-2022.
[2]	杨红燕, 陈圆圆, 陈燕琴, 等. 脑卒中患者运动耐受程度评估工具的研究进展[J]. 中华急危重症护理杂志, 2023, 4(1):87-91.
	Yang HY, Chen YY, Chen YQ, et al. Research progress of assessment tools for exercise tolerance in patients with stroke[J]. Chin J Emerg Crit Care Nurs, 2023, 4(1):87-91.
[3]	Wagner M, Brandt M. Long-term care provision and the well-being of spousal caregivers:an analysis of 138 European regions[J]. J Gerontol B Psychol Sci Soc Sci, 2018, 73(4):e24-e34.
[4]	靳瑾, 崔一凡, 韩斌如, 等. 机器人在危重症患者护理中的应用现状及挑战[J]. 中华急危重症护理杂志, 2024(8):713-717.
	Jin J, Cui YF, Han BR, et al. The current status and challen-ges of robot application in critical nursing care[J]. Chin J Emerg Crit Care Nurs, 2024(8):713-717.
[5]	Tomida K, Sonoda S, Hirano S, et al. Randomized controlled trial of gait training using gait exercise assist robot(GEAR) in stroke patients with hemiplegia[J]. J Stroke Cerebrovasc Dis, 2019, 28(9):2421-2428. doi: S1052-3057(19)30299-X pmid: 31307899
[6]	中国老年保健医学研究会老龄健康服务与标准化分会, 《中国老年保健医学》杂志编辑委员会, 北京小汤山康复医院. 中国高龄脑卒中患者康复治疗技术专家共识[J]. 中国老年保健医学, 2019, 17(01):3-16.
	Aging Health Service and Standardization Branch of Chinese Geriatric Health Care Medicine Research Association, Editorial Board of Chinese Geriatric Health Care Medicine Journal, Beijing Xiaotangshan Rehabilitation Hospital. Chinese elderly stroke patients rehabilitation treatment techno-logy experts consensus[J]. Chin J Geriatr Care, 2019, 17(1):3-16.
[7]	常震英, 沈可, 马骏, 等. 代谢车测定法在老年冠心病营养治疗中的应用效果[J]. 中外医学研究, 2024, 22(33):32-35.
	Chang ZY, Shen K, Ma J, et al. Effect of metabolic vehicle measurement in the nutritional treatment of coronary heart disease in the elderly[J]. Chin Foreign Med Res, 2024, 22(33):32-35. doi: 10.14033/j.cnki.cfmr.2024.33.009
[8]	吕雨梅, 郭玉成, 周郁秋. 脑卒中患者康复锻炼依从性发展轨迹及其潜在类别预测因素分析[J]. 中华护理杂志, 2023, 58(17):2103-2111. doi: 10.3761/j.issn.0254-1769.2023.17.008
	Lü YM, Guo YC, Zhou YQ. Research on the developmental tra-jectory of rehabilitation exercise adherence and its potential classes predictors in stroke patients[J]. Chin J Nurs, 2023, 58(17):2103-2111.
[9]	薛蓉, 王雪静, 杨润平, 等. 基于接纳承诺疗法的心理护理方案在终末期癌症患者中的应用研究[J]. 中华护理杂志, 2024, 59(15):1832-1839. doi: 10.3761/j.issn.0254-1769.2024.15.006
	Xue R, Wang XJ, Yang RP, et al. The application of a psy-chological nursing programme based on acceptance and com-mitment therapy in end-stage cancer patients[J]. Chin J Nurs, 2024, 59(15):1832-1839.

[1]	幸超群, 严艳, 王洁, 高娥, 张明月, 高传英. 缺血性脑卒中患者早期非偏瘫侧渐进式抗阻运动方案的构建及效果研究[J]. 中华急危重症护理杂志, 2025, 6(7): 773-779.
[2]	王伟钟, 周尧英, 刘伟董. 人工气道阻力智慧预警系统的研发及应用研究[J]. 中华急危重症护理杂志, 2025, 6(6): 671-675.
[3]	章夏萍, 罗松娜. 脑卒中患者运动恐惧研究的范围综述[J]. 中华急危重症护理杂志, 2025, 6(5): 624-630.
[4]	黄裕丰, 董丽霞, 张蕾, 王慧. 内蒙古地区急性缺血性脑卒中溶栓患者护理流程的改进及效果评价[J]. 中华急危重症护理杂志, 2025, 6(3): 345-350.
[5]	祝晓娟, 虞杨, 王聪, 尹君莲, 镇雨珊, 王德生, 柏慧华. 急性缺血性脑卒中患者机械取栓术后血压管理的最佳证据总结[J]. 中华急危重症护理杂志, 2025, 6(3): 365-371.
[6]	王燕卢芳燕王芳吴君. 短肠综合征患儿小肠移植术后早期移植肠康复的护理[J]. 中华急危重症护理杂志, 2024, 5(5): 451-454.
[7]	辛晨盖玉彪郭小靖张梦张宇辰魏丽丽. 静脉-静脉体外膜肺氧合患者早期康复干预的研究进展[J]. 中华急危重症护理杂志, 2023, 4(9): 855-859.
[8]	王丹华陈金刘海迎黄冬雪李旭光高燕原志芳林梅沈悦好. 心脏瓣膜置换术后患者ICU卧床期间早期康复的最佳证据总结[J]. 中华急危重症护理杂志, 2023, 4(8): 704-710.
[9]	彭俏俏杨湘英曾小康. 机械通气患者防滑脱计数握力器的设计及应用[J]. 中华急危重症护理杂志, 2023, 4(8): 700-703.
[10]	卞红俞萍孙芹何平. 渐进式康复操在ICU机械通气患者中的应用研究[J]. 中华急危重症护理杂志, 2023, 4(8): 689-694.
[11]	周丽萍叶欢娄洁香褚惠林朱陈萍. 急性脑卒中筛查量表的研究进展[J]. 中华急危重症护理杂志, 2023, 4(7): 664-669.
[12]	洪慧闫丹萍王钰炜张瑞. 急性缺血性卒中患者溶栓流程的优化及效果评价[J]. 中华急危重症护理杂志, 2022, 3(4): 354-.
[13]	何盼盼卢芳燕. 小肠移植受者再次行肝肠联合移植的术后护理[J]. 中华急危重症护理杂志, 2022, 3(4): 345-.
[14]	辛晨魏丽丽盖玉彪郭小靖张艳张宇辰. 静脉-静脉体外膜肺氧合患者早期康复方案的构建[J]. 中华急危重症护理杂志, 2022, 3(4): 305-.
[15]	李东燕蒋美丹赵莹章玲霞王晶晶. 早衰综合征并发脑卒中患儿的护理[J]. 中华急危重症护理杂志, 2022, 3(3): 218-.