量化评估策略框架下分阶段康复训练在ICU机械通气患者中的应用

Application of staged rehabilitation training in ICU patients receiving mechanical ventilation under the framework of quantitative assessment strategy

目的探讨量化评估策略框架下分阶段康复训练对ICU重症肺炎机械通气患者的呼吸困难状况、运动功能及肺功能的影响,旨在为临床工作提供科学依据。方法采用便利抽样法,选取2018年4月—2020年4月首都医科大学宣武医院的104例ICU重症肺炎机械通气患者为研究对象,按照随机数字表法分为对照组与观察组,每组52例。对照组给予常规康复训练,观察组基于对照组给予量化评估策略框架下分阶段康复训练。比较两组患者的并发症发生率、机械通气时间、ICU入住时间、足量肠内营养达标时间、护理满意度,比较两组患者入ICU时、ICU转出时、出院时的呼吸困难评分量表(MRC)评分、运动功能及肺功能[呼吸峰流量(PEF)、1 s用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)]。结果观察组患者的机械通气、ICU入住及足量肠内营养达标时间均短于对照组,差异有统计学意义(P<0.01)。ICU转出时、出院时,观察组患者的PEF、FEV1、FEV1/FVC、运动功能高于对照组,MRC评分低于对照组,差异有统计学意义(P<0.05)。观察组患者的并发症发生率为9.62%(5/52),低于对照组的25.00%(13/52),差异有统计学意义(P<0.05)。观察组患者的护理满意度高于对照组,差异有统计学意义(P<0.01)。结论在ICU重症肺炎机械通气患者管理工作中,量化评估策略框架下分阶段康复训练能通过针对性规范化训练减轻患者呼吸困难症状,改善肺功能,增强运功能力,并有助于降低并发症风险,加速疾病康复进程。

Objective To explore the effects of staged rehabilitation training on the dyspnea,motor function,and lung function of mechanically ventilated patients with severe pneumonia in ICU under the framework of a quantitative assessment strategy,and provide a scientific basis for clinical work.Methods Totally 104 mechanically ventilated patients with severe pneumonia in ICU at Xuanwu Hospital,Capital Medical University from April 2018 to April 2020 were selected by the convenient sampling method,and divided into the control group and the observation group according to the random number table,with 52 patients in each group.Patients in the control group received conventional rehabilitation training,while patients in the observation group underwent staged rehabilitation training under the framework of quantitative assessment strategy on the basis of the training provided to the control group.The incidence of complications,mechanical ventilation time,ICU stay time,compliance time of adequate enteral nutrition,and nursing satisfaction were compared between the two groups of patients.The dyspnea scores,Medical Research Council(MRC)score,motor function,and lung function[peak respiratory flow(PEF),forced expiratory volume in 1 s(FEV1),FEV1/forced vital capacity(FVC)]of the two groups were compared when they were admitted into the ICU,transferred from the ICU,and discharged from the hospital.Results The mechanical ventilation time,ICU stay time,and compliance time of adequate enteral nutrition in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.01).The PEF,FEV1,FEV1/FVC,and motor function in the observation group were higher than those in the control group,and the MRC score was lower than that in the control group,with statistically significant differences(P<0.05).The incidence of complications in the observation group was 9.62%(5/52),which was lower than 25.00%(13/52)in the control group,and the difference was statistically significant(P<0.05).The nursing satisfaction in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.01).Conclusions In the management of mechanically ventilated patients with severe pneumonia in the ICU,staged rehabilitation training under the framework of quantitative assessment strategies can reduce the symptoms of dyspnea,improve lung function,enhance mobility,and reduce the risk of complications through targeted and standardized training,which also helps to speed up disease recovery.