早期四级康复训练对ICU机械通气患者肌力、功能独立性及并发症的影响

目的 探讨早期四级康复训练在ICU机械通气患者中的应用价值。 方法 将2016年2月-2018年6月ICU收治的92例机械通气患者以随机数字表法分组,观察组与对照组各46例,对照组接受常规护理,观察组在对照组基础上加用早期四级康复训练,对2组患者康复情况、肌力、功能独立性、并发症发生率予以观察。 结果 观察组机械通气时间、ICU住院时间及总住院时间均较对照组短(t=15.400,P<0.001; t=13.044,P<0.001; t=4.611,P<0.001);2组患者英国医学研究委员会六级肌力评定法(the UK medical research council, MRC)评分在时间效应及组间效应上比较,差异均有统计学意义(F_时间=6.578,P=0.001;F_组间=8.924,P<0.001);观察组患者气管插管拔除时、转出ICU时的运动及认知评分均较对照组高;观察组患者ICU获得性衰弱、深静脉血栓、压疮、呼吸机相关性肺炎发生率均低于对照组。 结论 早期四级康复训练能提高ICU机械通气患者肌力,也能改善其功能独立性,预防并发症发生,促进患者康复,值得推广。

Influence of early four-level rehabilitation training on muscle strength,functional independence and complications of patients with mechanical ventilation in ICU

Objective To explore the application value of early four-level rehabilitation training in the nursing of patients with mechanical ventilation in ICU. Methods Totally 92 patients with mechanical ventilation and treated in ICU between February 2016 and June 2018 were randomly divided into an observation group and a control group, each of 46. Both groups received routine nursing, while the observation group were additionally given early four-level rehabilitation training. Then, the rehabilitation, muscle strength, functional independence and incidence of complications of two groups were observed. Results The mechanical ventilation time, ICU stay and hospital stay of the observation group were significantly shorter than those of the control group (t=15.400, P<0.001; t=13.044, P<0.001; t=4.611, P<0.001). Significant differences were observed in the average British Medical Research Council muscle strength assessment (MRC) score before and after the intervention for both groups, with the improvement of the observation group significantly greater than the control group. The movement and recognition scores of the observation group at the tracheal intubation extraction and leaving ICU were significantly than that of the control group, while the incidence of ICU acquired weakness, deep venous thrombosis, pressure sore and ventilator-associated pneumonia of the former was significantly lower than the latter. Conclusion The early four-level rehabilitation training can improve the muscle strength of patients with mechanical ventilation in ICU, better their functional independence, prevent their complications, and promote their rehabilitation. Therefore, it is worth of promoting.