标准化早期床上运动在EICU机械通气患者中的应用及对谵妄的预防效果

Application of Standardized Early Bed Exercise in EICU Patients with Mechanical Ventilation and Its Preventive Effect on Delirium

目的:观察标准化早期床上运动在EICU机械通气患者中的应用及对谵妄的预防效果。方法:选择2018年5月-2020年5月于医院治疗的132例EICU机械通气患者进行研究,以不同病例前-后对照试验方法对患者分组,66例为研究组,66例为对照组,对照组患者给予常规床上活动,研究组患者给予标准化早期床上运动,采用重症监护谵妄筛查量表(ICDSC)评估患者谵妄情况,记录两组患者谵妄首次出现时间、谵妄持续时间、机械通气时间、镇痛剂使用时间,采用Zung焦虑自评量表(SAS)评价患者负性情绪。结果:入住EICU 48 h内,两组患者谵妄发生率比较,差异无统计学意义(P>0.05);入住EICU 48~72 h、72 h后,研究组患者谵妄发生例数较少,谵妄总发生率低于对照组(P<0.05)。研究组患者谵妄持续时间、机械通气时间、镇痛剂使用时间短于对照组(P<0.05),研究组谵妄首次出现时间晚于对照组(P<0.05),研究组护理后患者SAS评分低于对照组(P<0.05)。结论:标准化早期床上运动干预EICU机械通气患者,可降低谵妄发生率,减少谵妄持续时间、机械通气时间、镇痛剂使用时间,延长谵妄首次出现时间,缓解患者焦虑情绪。

Objective:To observe the application of standardized early bed exercise in patients with EICU mechanical ventilation and its preventive effect on delirium.Method:A total of 132 patients treated with mechanical ventilation in EICU of our hospital from May 2018 to May 2020 were studied.The patients were divided into two groups by pre-and post-control experiments,66 patients in the control group were given routine bed activities,66 patients in the study group were given standardized early bed exercise.An intensive care delirium screening scale(ICDSC)was used to assess delirium,the first onset of delirium,duration of delirium,time of mechanical ventilation,time of use of analgesics were recorded.The Zung anxiety self-rating scale(SAS)was used to evaluate the negative emotion of the patients.Result:There was no significant difference in the incidence of delirium between the two groups within 48 hours after admission(P>0.05);after 48 to 72 hours and 72 hours in EICU,the cases of delirium in the study group were less than those in the control group,and the total incidence of delirium was lower than that in the control group(P<0.05).The delirium duration,mechanical ventilation time and analgesic time in the study group were shorter than those in the control group(P<0.05).The delirium first appeared in the study group was later than that in the control group(P<0.05).The SAS score of the study group after nursing was lower than that of the control group(P<0.05).Conclusion:Standardized early bed exercise intervention EICU mechanical ventilation,which can reduce the incidence of delirium,reduce delirium duration,mechanical ventilation time,analgesic time,prolong the onset of delirium,relieve anxiety in patients.