早期康复训练治疗ICU获得性肌无力的临床效果

Clinical effect of early rehabilitation training in the treatment of ICU acquired myasthenia gravis

目的探讨早期康复训练治疗ICU获得性肌无力的临床效果。方法选择2015年12月~2018年6月我院收治的80例ICU获得性肌无力患者作为研究对象,根据随机数字表法将其分为早期组与对照组,每组各40例。对照组患者采取镇静、抗生素、营养支持等治疗,早期组患者在对照组的基础上采用早期康复治疗。比较两组患者的临床疗效、机械通气评分、住院时间、ICU住院时间、并发症发生率及治疗前后日常生活能力评分、英国医学研究理事会总分、生活质量总分、急性生理与慢性健康(APACHEⅡ)评分。结果早期组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组患者治疗前的日常生活能力评分、英国医学研究理事会总分、生活质量总分、APACHEⅡ评分比较,差异无统计学意义(P>0.05);两组患者治疗后的日常生活能力评分、英国医学研究理事会总分、生活质量总分均高于治疗前,APACHEⅡ评分均低于治疗前,差异有统计学意义(P<0.05);早期组患者治疗后的日常生活能力评分、英国医学研究理事会总分、生活质量总分均高于对照组,APACHEⅡ评分低于对照组,差异有统计学意义(P<0.05)。早期组患者的机械通气评分低于对照组,住院时间及ICU住院时间均短于对照组,差异有统计学意义(P<0.05)。早期组患者的并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论在镇静、抗生素、营养支持等基础上,采用早期康复治疗ICU获得性肌无力效果好。

Objective To investigate the clinical effect of early rehabilitation training in the treatment of ICU acquired myasthenia gravis.Methods Eighty patients with ICU acquired myasthenia gravis admitted to our hospital from December 2015 to June 2018 were enrolled in the study.They were divided into the early group and the control group according to the random number table method,40 cases in each group.Patients in the control group were treated with sedation,antibiotics,and nutritional support,and the patients in the early group were treated with early rehabilitation on the basis of the control group.The clinical efficacy,mechanical ventilation score,hospitalization time,ICU hospitalization time,complication rate,and daily living ability score,total score of the UK medical research council,total score of life quality,acute physiology and chronic health evaluation(APACHEⅡ)score before and after treatment were compared between the two groups.Results The total effective rate of treatment in the early group was higher than that in the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the score of daily living ability,the total score of the UK medical research council,the total score of life quality,and the APACHEⅡscore between the two groups before treatment(P>0.05).The scores of daily living ability,the total scores of the UK medical research council and the total scores of life quality in the two groups after treatment were higher than those before treatment,the APACHEⅡscores were lower than those before treatment,and the differences were statistically significant(P<0.05).The score of daily living ability,the total score of the UK medical research council and the total score of life quality in the early group after treatment were higher than those in the control group,the APACHEⅡscore was lower than that in the control group,and the differences were statistically significant(P<0.05).The mechanical ventilation score in the early group was lower than that in the control group,the hospitalization time and ICU hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).The incidence rate of complications in the early group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion On the basis of sedation,antibiotics and nutritional support,the early rehabilitation is good in the treatment of ICU acquired myasthenia gravis.