Objective To investigate the effects of early resistance training on the success rate of ventilator weaning,off-line efficiency and activity ability in patients with severe respiratory diseases,and to provide guidance for the early rehabilitation of patients with severe respiratory diseases. Methods We selected 64 patients who were admitted to Intensive Care Unit of Respiratory Department of our hospital and received mechanical ventilation from January 2019 to January 2020 as study subjects,and were randomly divided into experimental group and control group with 32 patients in each group. The control group received routine nursing,and the experimental group received early resistance weaning training program led by nurses. The differences of offline success rate,offline efficiency and activity ability after intervention were compared between the two groups. Results After the early resistance off-line training,the success rate of the experimental group was significantly higher than that of the control group（90.63% vs. 65.63%,P=0.015）,the duration of ventilator use was significantly lower than that of the control group[（10.80±2.20）d vs.（14.00±3.50）d,P=0.028],and the incidence of complications was lower（43.75% vs. 68.75%,P=0.014）. The activity ability of experimental group on day 1 and day 3 after offline was significantly better than that of control group（P<0.001）. Conclusion Early resistance off-line training can improve the success rate and off-line efficiency of severe patients,improve the activity level of patients,and promote their disease rehabilitation.
[1] 朱兴旺. 3种无创通气模式应用于早产儿有创机械通气撤离后呼吸支持的多中心随机对照研究[J]. 中华围产医学杂志,2022,25(8):600.
Zhu XW.Multi-center randomized controlled study of three non-invasive ventilation modes applied to respiratory support of premature infants after invasive mechanical ventilation evacuation[J]. Chin J Perinat Med,2022,25(8):600.
[2] 丁舒,高凤莉. 台湾地区呼吸机依赖患者整合性照护发展现状及启示[J]. 中国护理管理,2018,18(12):1689-1691.
Ding S,Gao FL.Development of integrated care in mechanical ventilator-dependent patients in China Taiwan area and its enlightenment[J]. Chin Nurs Manag,2018,18(12):1689-1691.
[3] 秦妍,胡静,陆国平,等. 呼吸机依赖患儿家庭延续护理的实践[J]. 中华护理杂志,2018,53(5):548-552.
Qin Y,Hu J,Lu GP,et al.Research on continuing nursing model for ventilator-dependent children in China[J]. Chin J Nurs,2018,53(5):548-552.
[4] 杨萍,吕慧颐. 1例颌面颈部多间隙感染伴纵隔脓肿呼吸机依赖病人呼吸康复训练成功脱机的护理[J]. 护理研究,2017,31(25):3215-3216.
Yang P,Lü HY.Nursing Care of a case of ventilator dependent patient with combined maxillofacial and cervical multi-gap infection and mediastinal abscess with successful offline after respiratory rehabilitation training[J]. Chin Nurs Res,2017,31(25):3215-3216.
[5] Nicolotti D,Grossi S,Nicolini F,et al.Difficult respiratory weaning after cardiac surgery:a narrative review[J]. Clin Med,2023,12(2):497.
[6] 刘绍,王丽雯,王素梅,等. 肺康复在机械通气患者中应用效果的Meta分析[J]. 中华急危重症护理杂志,2021,2(2):140-145.
Liu S,Wang LW,Wang SM,et al.Pulmonary rehabilitation in patients with mechanical ventilation:a meta-analysis[J]. Chin J Emerg Crit Care Nurs,2021,2(2):140-145.
[7] 李雪,单岩,蒋婷婷,等. 抗阻运动在维持性血液透析合并肌少症病人护理中的应用研究进展[J]. 护理研究,2021,35(4):643-647.
Li X,Shan Y,Jiang TT,et al.Research progress on resistance exercise applied in nursing care of patients with maintenance hemodialysis complicated with sarcopenia[J]. Chin Nurs Res,2021,35(4):643-647.
[8] 王硕,姜灿,张晓雪,等. 早期渐进式抗阻运动方案对胰腺手术术后患者临床结局的影响及安全性评价[J]. 中国护理管理,2021, 21(3):325-330.
Wang S,Jiang C,Zhang XX,et al.Effects of early progressive resistance exercise program on the clinical outcome of patients after pancreatic surgery and its safety evaluation[J]. Chin Nurs Manag,2021,21(3):325-330.
[9] Kirkman DL,Lee DC,Carbone S.Resistance exercise for cardiac rehabilitation[J]. Prog Cardiovasc Dis,2022,70:66-72.
[10] 黄子叶,韩媛,王艳玲. 抗阻运动对COPD患者运动耐力、肺功能和生活质量影响的Meta分析[J]. 中华现代护理杂志,2019,25(14):1726-1731.
Huang ZY,Han Y,Wang YL.Effects of resistance training on exercise endurance,pulmonary function and quality of life in patients with chronic obstructive pulmonary disease:a Meta-analysis[J]. Chin J Mod Nurs,2019,25(14):1726-1731.
[11] Cheung AK,Chang TI,Cushman WC,et al.Executive summary of the KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease[J]. Kidney Int,2021,99(3):559-569.
[12] Hodgson CL,Stiller K,Needham DM,et al.Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults[J]. Crit Care,2014,18(6):658.
[13] 管向东,刘紫锰. 2013《呼吸机相关性肺炎诊断、预防和治疗指南》:目标性治疗的解读[J]. 中华医学杂志,2014,94(5):333-334.
Guan XD,Liu ZM.Guidelines for Diagnosis,Prevention and Treatment of Ventilator-associated Pneumonia in 2013—interpretation of targeted therapy[J]. Natl Med J China,2014,94(5):333-334.
[14] Perme C,Nawa RK,Winkelman C,et al.A tool to assess mobility status in critically ill patients:the Perme Intensive Care Unit Mobility Score[J]. Methodist Debakey Cardiovasc J,2014,10(1):41-49.
[15] 何玲英,黄丽华,张月丽. 佩尔梅危重患者活动评分量表的汉化及信效度检测[J]. 护理与康复,2017,16(11):1144-1148.
He LY,Huang LH,Zhang YL.Chinesization on Perme Intensive Care Unit Mobility Scale and assessment on its reliability and validity[J]. J Nurs Rehabil,2017,16(11):1144-1148.
[16] 吴晶,田宇红,李盼盼,等. 早期肺康复训练在AECOPD患者机械通气治疗中的临床意义[J]. 中华肺部疾病杂志(电子版),2022,15(1):42-46.
Wu J,Tian YH,Li PP,et al.Clinical significance of early lung rehabilitation training in mechanical ventilation treatment of AECOPD patients[J]. Chin J Lung Dis Electron Ed,2022,15(1):42-46.
[17] da Silva Guimarães B,de Souza LC,Cordeiro HF,et al. Inspiratory muscle training with an electronic resistive loading device improves prolonged weaning outcomes in a randomized controlled trial[J].Crit Care Med. 2021,49(4):589-597.
[18] Charatcharoenwitthaya P,Kuljiratitikal K,Aksornchanya O,et al.Moderate-intensity aerobic vs resistance exercise and dietary modification in patients with nonalcoholic fatty liver disease:a randomized clinical trial[J]. Clin Transl Gastroenterol,2021, 12(3):e00316.
[19] Olvera-Soto MG,Valdez-Ortiz R,López Alvarenga JC,et al.Effect of resistance exercises on the indicators of muscle reserves and handgrip strength in adult patients on hemodialysis[J]. J Ren Nutr,2016,26(1):53-60.
[20] Frih B,Jaafar H,Mkacher W,et al.The effect of interdialytic combined resistance and aerobic exercise training on health related outcomes in chronic hemodialysis patients:the Tunisian randomized controlled study[J]. Front Physiol,2017,8:288.
[21] 黄志萍,劳玉妹,肖丹丹. 基于HAPA模式的渐进式抗阻训练对老年慢性阻塞性肺气肿患者健康行为和运动耐力的影响[J]. 中华肺部疾病杂志(电子版),2021,14(1):37-42.
Huang ZP,Lao YM,Xiao DD.Effect of progressive resistance training based on HAPA model on the health behavior and exercise endurance of elderly patients with chronic obstructive pulmonary emphysema[J]. Chin J Lung Dis Electron Ed,2021,14(1):37-42.
