早期MDT集束化干预策略对ICU患儿获得性衰弱的研究

Intervention study of early MDT clustering intervention strategy on acquired weakness of children in ICU

目的探讨早期多学科团队(MDT)集束化干预策略对危重症患儿ICU获得性衰弱的临床效果。方法收集2018年11月-2019年4月就诊于本院儿科重症监护室住院的患儿90例,采用随机等分法将其分为干预组和对照组,各45例。对照组接受常规治疗,干预组接受早期MDT集束化干预策略下的集多学科合作的治疗、护理、心理、康复一体化共同治疗。比较两组重症监护室患儿接受治疗时发生ICU获得性衰弱的情况、机械通气及总住院天数时间、对护理舒适度的差异。结果干预组患儿在ICU的不同时段中,获得性衰弱发生率均显著低于对照组(P<0.05);干预组患儿在生理、心理、精神、社会和环境四个维度评分及总评分均高于对照组(P<0.05);干预组机械通气时间、拔管时间、住ICU时间、住院时间均显著短于对照组,住院费用明显少于对照组(P<0.05)。结论早期应用MDT提出的集束化干预策略能够有效改善重症监护室患儿发生ICU获得性衰弱的情况,提高患儿生活质量,缩短住院时间,减少住院费用。

Objective To explore the clinical effect of early MDT cluster intervention strategy on ICU acquired weakness(AW)in critically ill children.Methods A total of 90 children hospitalized in the pediatric intensive care unit of our hospital from November 2018 to April 2019 were collected and divided into intervention group and control group by random bisection method.The control group received routine undergraduate treatment,while the intervention group received multidisciplinary cooperation treatment,nursing,psychological and rehabilitation integrated treatment under the early MDT cluster intervention strategy mentioned in this study.The difference of ICU-AW,mechanical ventilation,total hospital stay and nursing comfort between the two groups were compared.Results The incidence of AW in the intervention group was significantly lower than that in the control group in different periods of ICU(P<0.05).The scores of physical,psychological,spiritual,social and environmental dimensions and the total scores in the intervention group were higher than those in the control group(P<0.05).The duration of mechanical ventilation,extubation,ICU stay and hospital stay of the intervention group were significantly shorter than those of the control group,and the hospitalization expenses of the intervention group were significantly less than those of the control group(P<0.05).Conclusion Early application of the cluster intervention strategy proposed by MDT can effectively improve the ICU acquired weakness of children,improve the quality of life of children,shorten the length of hospital stay and reduce hospital costs.