早期渐进性康复训练对机械通气重症患者神经肌肉功能恢复的影响

Effect of Early Progressive Rehabilitation Training on the Recovery of Neuromuscular Function in Patients with Severe Mechanical Ventilation

目的:探讨早期渐进性康复训练对行机械通气重症患者神经肌肉功能的影响。方法:选择我院自2015年4月~2016年4月收治的80例机械通气重症患者。通过随机数字表法将患者分为观察组及对照组各40例,患者进入ICU后,给予所有患者常规的机械通气治疗方案及干预。在此基础上给予观察组患者早期渐进性康复训练,分别于气管插管拔管时、转出ICU时以及出院时采用功能独立性评分表(FIM)对两组患者功能独立性水平进行评价,统计比较两组患者机械通气时间、ICU治疗时间、住院总时间及并发症的发生情况。结果:气管插管拔管时观察组自理能力、括约肌控制、转移功能及总分水平均高于对照组,差异均有统计学意义(均P<0.05)。转出ICU时和出院时观察组自理能力、括约肌控制、转移、行进、交流、社会认知及总分水平均高于对照组,差异均有统计学意义(均P<0.05)。观察组机械通气时间、ICU治疗时间及住院总时间及并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:早期渐进性康复训练可有效者提高ICU患者自理能力,加速患者意识的恢复,使患者更早的脱机,减少住院时间,降低并发症情况的发生。

Objective： To investigate the effect of early progressive rehabilitation training on the neuromuscular function of patients with severe mechanical ventilation. Methods： Selected 80 patients with mechanical ventilation in severe our hospital from April2015 April 2016. The patients were divided into observation group and control group by random number table method, each of 40 cases,after entering the ICU, they were given conventional mechanical ventilation. On this basis, the observation group was given early progressive rehabilitation training, evaluated the level of functional independence in two groups by functional independence measure（FIM） when the patients tracheal extubation, turn out ICU and discharge the hospital respectively, and compared the mechanical ventilation time, ICU treatment time, and total time in hospital, as well as the occurrence of complications in two groups. Results： The self-care ability, sphincter control, move function and total score in observation group were higher than control group when tracheal extubation, differences were statistically significant（all P〈0.05）, self-care ability, sphincter control, move, walk, communication,social cognition and total scores were higher than the control group when turn out ICU and discharge the hospital respectively, the differences were statistically significant（all P〈0.05）. Observation group mechanical ventilation time and ICU treatment time and total time in hospital and the complication rate is lower than the control group, the differences were statistically significant（P〈0.05）. Conclusion： Using Early progressive rehabilitation training for treating the patients with severe mechanical ventilation,it can effectively improve the self-care ability, accelerate the recovery of consciousness and weaning,reduce the hospital stay, and reduce the incidence of complications of patients.