新型冠状病毒肺炎住院患者康复介入原则与策略

Principle and Strategy of Rehabilitation Intervention for Inpatients with COVID-19

当前,新型冠状病毒肺炎(COVID-19)疫情形势仍较严峻。基于传染性呼吸系统疾病的临床特点,探索性地论述COVID-19住院期康复介入的原则与策略,以期为COVID-19及其他传染性呼吸系统疾病住院期间如何安全、有效地开展康复治疗工作提供借鉴。预防、治疗、康复一体化是COVID-19康复介入的根本依据,在疾病急性期的病情稳定阶段,康复介入越早,预后越好。缺氧是所有COVID-19住院患者面临的主要临床问题,通过康复医学的系统管理手段安全有效地解决疾病导致的缺氧状态成为住院期康复最佳介入点。基于此,本研究提出COVID-19住院患者康复介入应多学科医疗团队合作,以共同目标管理为导向,把握“不越位、不缺位”原则,应用“节能减排”康复策略,以一系列身-心层面的维稳、放松、降耗作为主要手段,同时评估、干预个体与环境的交互作用,将COVID-19的防控要求纳入康复管理过程。COVID-19住院患者的康复介入不仅是技术介入,更是一个系统管理的过程。以系统观的视角选择增进健康效益的手段,体现了康复医学中最重要的“以人为本”理念,意识到康复医学多元化的内涵并加以运用,将为康复治疗工作者提供新的思路。

To provide references for safe and effective implementing rehabilitation treatment during hospitalization,in this article,we exploratively discusses the principle and strategy of treatment for inpatients with COVID-19 based on clinical characteristics as infectious pulmonary diseases.The foundation of rehabilitation intervention in COVID-19 is'integration of prevention,treatment and rehabilitation'frame.The earlier the rehabilitation intervention starts,the better the prognosis will be,in the stable stage of the disease.Anoxia is the main clinical manifestation for inpatients with COVID-19.The best intervention point for inpatient's rehabilitation may be resolving the disease-caused anoxia via systemic management approaches safely and efficiently in rehabilitation medicine.Thus,this article proposes that we should keep on the principle,'No Excess,No Absence',and use the strategy basing on'Energy Conservation and Emission Reduction'as common goal management in the cooperation of multidisciplinary team approach on inpatient of COVID-19 rehabilitation.The series of stabilization,relaxation and energy-saving on'physical-mental level'were the major methods.And meanwhile the interaction among evaluation and intervention on individual and environment at the same time with the inclusion of COVID-19 prevention and control will rule into rehabilitation management process.The rehabilitation intervention on COVID-19 inpatients is not only the technique-oriented but also a systemic management process.The option of health efficacy promotion approaches via systemic vision is the demonstration of the most important concept in rehabilitation medicine,'People Frist of All'.The cognition on various meaning in rehabilitation medicine will provide new for rehabilitation field.