早期肺康复在ICU机械通气患者中的应用效果

Effects of Early Pulmonary Rehabilitation in ICU Mechanical Ventilation Patients

目的:探讨早期肺康复在重症监护病房(ICU)机械通气患者中的应用效果。方法:选取本院ICU 2017年3月~2019年6月收治的机械通气患者124例,随机分为对照组和康复组各62例。对照组给予常规治疗和护理,康复组在对照组的基础上加用早期肺康复锻炼。比较两组治疗前后的呼吸频率(RR)、心率(HR)、氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)、急性生理与慢性健康评分(APACHEⅡ)评分,记录患者的机械通气时间、ICU住院天数、总住院天数、再插管率及呼吸机相关性肺炎(VAP)发生率。结果:两组治疗后的RR、HR、PaCO2、APACHEⅡ评分均较治疗前降低,且观察组均低于对照组,(P<0.05);两组治疗后PaO2、PaO2/FiO2、MRC评分均较治疗前升高,且观察组均高于对照组(P<0.05);观察组机械通气时间、ICU住院天数和总住院时间均短于对照组(P<0.05);观察组再插管率和VAP发生率均低于对照组(P<0.05)。结论:早期肺功能可以提高ICU机械通气患者的肺功能,改善氧合指数,缩短机械通气时间和住院时间,降低再插管率和VAP发生率。

Objective: To study the effects of early pulmonary rehabilitation in patients with mechanical ventilation in intensive care unit(ICU). MMeetthh-ods: 124 patients with mechanical ventilation admitted to our hospital from March 2017 to June 2019 were randomly divided into two groups: control group and rehabilitation group. The control group received routine treatment and care, and the rehabilitation group added early pulmonary rehabilitation on the basis of routine treatment and care in the control group. The respiratory rate(RR), heart rate(HR), oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2), oxygenation index(PaO2/FiO2), acute physiology and chronic health score(APACHEⅡ) scores before and after treatment were compared between the two groups. The patient’s mechanical ventilation time, ICU hospital stay, total hospital stay, reintubation rate, and ventilator-associated pneumonia(VAP) incidence were recorded. Results: The RR, HR, PaCO2, and APACHEⅡ scores of the two groups were lower than those before treatment(P<0.05), and the observation group was lower than the control group(P<0.05). The PaO2, PaO2/FiO2, scores of MRC after treatment were higher than those before treatment(P<0.05), and the observation group was higher than the control group(P<0.05). The mechanical ventilation time, ICU hospital stay and total hospitalization time were shorter than the control group(P<0.05). The reintubation rate and VAP incidence in the observation group were lower than those in the control group(P<0.05). Conclusion: Early pulmonary rehabilitation can improve lung function, improve oxygenation index, shorten mechanical ventilation time and hospitalization time, reduce reintubation rate and VAP incidence in ICU patients with mechanical ventilation.