早期活动预防慢性阻塞性肺疾病机械通气患者ICU获得性衰弱的效果

Effect of Early Mobilization in Preventing ICU Acquired Weakness in Patients with COPD Mechanical Ventilation

目的探讨早期活动预防慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)机械通气患者ICU获得性衰弱(intensive care unit acquired weakness,ICU-AW)的效果。方法 2014年1月至2015年10月,采用便利抽样法选择南通市瑞慈医院重症医学科收治的80例COPD机械通气患者为研究对象,按入院先后将其分为对照组和观察组各40例,对照组患者给予常规护理,观察组患者在对照组的基础上进行早期活动,评价并比较两组患者干预前后的医学研究理事会评分(Medical Research Council score,MRC-score)及干预后ICU-AW的发生率。结果干预后,观察组与对照组MRC-Score评分均高于干预前,观察组评分高于对照组,差异均有统计学意义(均P<0.05);观察组和对照组ICU-AW的发生率分别为2.5%(1/40)、40%(16/40),两组比较,差异有统计学意义(P<0.05)。结论在保证安全,严格筛选适应证、禁忌证的前提下,早期活动预防COPD机械通气患者并发ICU-AW效果较好,值得在临床推广应用。

Objective To discuss the early mobilization in preventing intensive care unit acquired weakness （ICU-AW） in patient with chronic obstructive pulmonary disease （COPD） mechanical ventilation.Methods By convenience sampling, 80 cases were selected and divided into control group and observation group, with 40 cases in each group.The control group received routine care, while observation received early mobi- lization on the basis of control group.The medical research council score （MRC-score） before intervention and the incidence rate of ICU-AW after intervention in two group were compared.Results After interven- tion, the MRC-score in both groups were higher than before inter venion, and the score in observation group was higher than that of control group （all P〈0.05）.The incidence rate of ICU-AW in observation group and control group was 2.5% （1/40） and 40% （16/40）, respectively （P〈0.05）.Conclusion By ensuring the safety and strict screening of indications, contraindications, early prevention of COPD by mechanical ventilation patients complicated with ICU-AW have good effect, which is worth of clinical pro- motion.