ICU患者早期活动障碍及其影响因素分析

Analysis of the barriers of early mobilization and its influencing factors in ICU patients

目的 :识别ICU患者早期活动的障碍及其影响因素,为建立ICU患者早期活动方案提供临床参考。方法 :采用便利抽样方法,选取兰州市某三级甲等医院综合ICU的290例患者为研究对象进行横断面调查。设计早期活动记录单,根据不进行早期活动的原因识别早期活动的障碍,分析其影响因素。结果 :机械通气患者早期活动的主要障碍为气管插管、镇静;非机械通气患者早期活动的主要障碍为缺乏医生的支持、循环系统不稳定;Logistic回归分析显示早期活动的影响因素为ICU住院时间、肌力、机械通气时间。结论 :ICU患者早期活动的障碍较多,其影响因素较少,今后应在此基础上扩大影响因素探索的范围。

Objective： To identify the barriers and influencing factors of early mobilization in ICU patients, and aim to provide clinical reference for the establishment of early mobilization program. Methods： A convenienced sample of 290 patients were selected in ICU from a Level-3 Hospital in Lanzhou, and identified the barriers of early mobilization and its influencing factors by a self-designed early mobilization records. Results： The main barriers of the early mobilization in ICU patients with mechanical ventilation were tracheal intubation, sedation, and the main barriers of those without mechanical ventilation were lacking of physician support and instability of the circulatory system. The logistic regression showed that the related factors of early mobilization included the stays in ICU, muscle strength and duration of mechanical ventilation. Conclusion： There were many obstacles to early mobilization and the influencing factors of barriers was limited. It is necessary to know more about the influencing factors, and pay more attention to the barriers of the early mobilization of ICU patients.