张浩,卢滨,杨付红,等.早期康复干预治疗急性呼吸衰竭机械通气患者的疗效观察[J].中华物理医学与康复杂志,2020,42(12):1063-1066
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| 早期康复干预治疗急性呼吸衰竭机械通气患者的疗效观察 |
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| DOI：10.3760/cma.j.issn.0254-1424.2020.12.002 |
| 中文关键词: 急性呼吸衰竭 早期康复 ICU获得性衰弱 膈肌功能 |
| 英文关键词: Respiratory failure ICU-acquired weakness Diaphragm function |
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| 中文摘要: |
| 目的 观察早期康复干预治疗急性呼吸衰竭-机械通气患者的疗效。 方法 采用随机数字表法将77例急性呼吸衰竭-机械通气患者分为观察组（共39例）及对照组（共38例）。2组患者均给予重症监护病房（ICU）常规处理，观察组患者在此基础上辅以床上被动关节训练、吸气肌训练及床边主动训练等。对比2组患者ICU住院时间、机械通气时间、脱机成功率及ICU获得性衰弱(ICU-AW)发病率，并于拔管前采用超声检测2组患者膈肌厚度分数(DTF)指标。 结果 观察组患者ICU住院时间［(16.58±5.78)d］、机械通气时间［(201.57±26.67)h］均较对照组［分别为（22.54±6.21）d和（261.12±37.43）h］明显缩短(P<0.05)；观察组患者ICU-AW发病率(28.2%)较对照组发病率（44.7%）明显降低(P<0.05)；观察组患者脱机成功率(87.2%)较对照组成功率（68.4%)明显提高(P<0.05)；拔管前观察组患者DTF［(39.38±5.29)% ］较对照组［（26.95±8.69）%)］明显提高(P<0.05)。 结论 对急性呼吸衰竭-机械通气患者实施早期康复干预，能显著缩短患者ICU住院时间及机械通气时间，改善膈肌功能，提高脱机成功率，且治疗过程中安全性较好，该疗法值得临床进一步研究、推广。 |
| 英文摘要: |
| Objective To explore the effect of early rehabilitation with patients in acute respiratory failure receiving mechanical ventilation. Methods Seventy-seven patients in acute respiratory failure and receiving mechanical ventilation were randomly divided into an intervention group of 39 and a control group of 38. Both groups received conventional ICU treatment, while the intervention group was additionally provided with passive joint exercise, inspiratory muscle exercise and bedside active training. The time of ICU stay and mechanical ventilation, the weaning success rate and the incidence of ICU-acquired weakness (ICU-AW) were compared between the two groups. The subjects′ diaphragm thickness fractions (DTFs) were measured using ultrasound. Results The average length of ICU stay and of mechanical ventilation of the observation group were both significantly shorter than the control group′s averages. The incidence of ICU-AW in the observation group was also significantly lower than among the control group while the weaning success rate was significantly higher. Before extubation, the average DTF of the observation group was significantly greater than among the controls. Conclusion For acute respiratory failure patients receiving mechanical ventilation, early rehabilitation can significantly shorten their ICU stay and time on mechanical ventilation, improve their diaphragm function and their chance of being successfully weaned off mechanical ventilation. The intervention is safe and worthy of clinical promotion. |
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