基于eCASH理念指导下的健康管理在ICU老年机械通气患者中的应用

Application of health management based on eCASH concept in ICU elderly mechanical ventilation patients

目的探讨基于eCASH理念指导下的健康管理在重症监护病房(ICU)老年机械通气患者中的应用效果。方法选择2019年1月至12月中国人民解放军联勤保障部队第九○四医院收治的ICU老年机械通气患者88例,按照随机数字表法分为观察组44例、对照组44例(实际纳入42例)。对照组给予常规护理干预,观察组给予基于eCASH理念指导下的健康管理。比较两组机械通气治疗相关指标、谵妄与ICU获得性衰弱、重症监护体验。结果观察组机械通气时间、ICU住院时间、总住院时间短于对照组(P<0.05);谵妄、ICU获得性衰弱发生率明显低于对照组(P<0.05),谵妄状态持续时间明显短于对照组(P<0.01),MRC肌力评分明显高于对照组(P<0.05);环境感受、认知与感受改变、人际支持需求、治疗与病情信息、重症监护体验总分明显低于对照组(P<0.05)。结论基于eCASH理念指导下的健康管理有助于缩短机械通气及住院时间,降低谵妄与ICU获得性衰弱发生率,缓解重症监护痛苦体验。

Objective To explore the effect of health management based on eCASH concept in patients with intensive care unit(ICU)elderly mechanical ventilation.Methods A total of 88 elderly ICU patients with mechanical ventilation admitted to the 904th Hospital of Joint Logistic Support Force of the People’s Liberation Army from January to December 2019 were selected,according to random number table method,44 cases were divided into observation group and 44 cases in control group(42 cases were actually included).The control group was given routine nursing intervention,health management based on eCASH concept was given in the observation group.The mechanical ventilation treatment related indicators,delirium and ICU acquired debilitating,and intensive care experience were compared between two groups.Results The time of mechanical ventilation,ICU hospitalization and total hospitalization in observation group were significantly shorter than those in control group(P<0.05);the incidence of delirium and ICU acquired debilitating was significantly lower than that in the control group(P<0.05),delirium duration was significantly shorter than control group(P<0.01),the score of MRC muscle strength was significantly higher than that in the control group(P<0.05);environmental perception,cognitive and sensory changes,interpersonal support needs,treatment and disease information,the total score of intensive care experience were significantly lower than those in the control group(P<0.05).Conclusion Health management based on eCASH concept can shorten mechanical ventilation and hospital stay,reduce the incidence of delirium and ICU acquired debilitating,alleviate the painful experience of intensive care.