刘岩松,陆敏,侯牧韶,等.局部振动联合早期康复干预防治重症患者ICU获得性衰弱的疗效观察[J].中华物理医学与康复杂志,2025,47(9):827-833
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| 局部振动联合早期康复干预防治重症患者ICU获得性衰弱的疗效观察 |
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| DOI：10.3760/cma.j.cn421666-20250310-00211 |
| 中文关键词: 局部振动 早期康复 重症 ICU获得性衰弱 |
| 英文关键词: Vibration therapy Severe illness Intensive care Acquired weakness |
| 基金项目:2023年政府资助临床医学优秀人才培养项目（ZF2023121） |
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| 中文摘要: |
| 目的 观察局部振动联合早期康复干预防治重症患者ICU获得性衰弱（ICU-AW）的疗效及安全性。 方法 采用随机数字表法将96例重症患者分为对照组、康复组及联合组，每组32例。对照组给予常规治疗及护理，康复组在此基础上辅以早期康复干预，联合组则辅以局部振动疗法及早期康复干预。于治疗前、治疗2周后对3组患者进行疗效评估，具体评估项目包括ICU-AW发生率、急性生理与慢性健康评分-Ⅱ(APACHE-Ⅱ)、肌肉超声检查、机械通气时间、ICU住院时间、改良Barthel指数（MBI）评分及不良事件发生率等。 结果 干预后联合组ICU-AW发生率显著低于康复组及对照组水平（P<0.05），康复组ICU-AW发生率亦显著低于对照组水平（P<0.05）；联合组APACHE-Ⅱ评分显著低于康复组及对照组水平（P<0.05），康复组APACHE-Ⅱ评分亦显著低于对照组水平（P<0.05）；联合组股直肌、腹直肌、肱二头肌厚度、横截面积以及膈肌厚度、活动度均优于康复组及对照组（P<0.05），康复组上述指标亦显著优于对照组（P<0.05）；联合组机械通气时间及ICU住院时间均较康复组及对照组明显缩短（P<0.05），康复组上述指标时长亦显著短于对照组（P<0.05）；联合组MBI评分较康复组及对照组显著增加（P<0.05），康复组MBI评分亦显著高于对照组（P<0.05）；联合组不良事件发生率较康复组及对照组显著降低（P<0.05），康复组不良事件发生率亦显著低于对照组水平（P<0.05）。 结论 局部振动联合早期康复干预能改善重症患者肌肉功能，减少ICU-AW及不良事件发生率，且具有较高的安全性。 |
| 英文摘要: |
| Objective To explore the efficacy and safety of supplementing early rehabilitation with local vibration therapy in the prevention and treatment of ICU-acquired weakness (ICU-AW). Methods Ninety-six critically ill patients were randomly divided into a control group, a rehabilitation group, and a combination group, each of 32. All received routine treatment and care, but the rehabilitation group and the combination group received earlier rehabilitation and the combination group early rehabilitation + local vibration therapy. Before and after 2 weeks of the treatments, the incidence of ICU-AW was recorded, Acute Physiology and Chronic Health Evaluation II (APACHE-II) scoring was performed and ultrasound was used to detect the rehabilitation effect. The incidence of adverse events was also recorded. Results The incidence of ICU-AW was significantly lower in the combination group than among the rehabilitation group, while that of the rehabilitation group was significantly lower than among the control group. The APACHE II scores showed the same progression. The thickness, cross-sectional area, muscle echo, and diaphragm thickness and activity of the rectus femoris, rectus abdominis, and biceps brachii muscles in the combination group were, on average, significantly better than among the rehabilitation group, but with the rehabilitation group′s results significantly better than among the control group. The average mechanical ventilation time and ICU stay of patients in the combination group were significantly shorter than the rehabilitation group′s averages, which in turn were significantly shorter than those of the control group. The combination group′s average Barthel Index after the experiment was significantly higher than that of the rehabilitation group, which was in turn significantly higher than the control group′s average. The incidence of adverse events in the combination group was significantly lower than in the rehabilitation group, with that of the latter significantly lower than among the control group. Conclusions Combining local vibration therapy with early rehabilitation is beneficial for the safe prevention and treatment of ICU-AW. |
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