以护士为主导的早期活动方案对ICU机械通气患者康复及下肢深静脉血栓的影响

Effect of Nurse-led Early Activity Programme on Rehabilitation and Deep Venous Thrombosis of Lower Limbs in Patients with ICU Mechanical Ventilation

目的:探讨以护士为主导的早期活动方案在重症监护室(ICU)机械通气患者中的应用效果。方法:选择2018年9月~2020年9月某院ICU收治的88例机械通气患者,按随机数字表法分为对照组和观察组各44例,对照组采取常规护理,观察组实施以护士为主导的早期活动方案护理,比较两组机械通气时间、ICU住院时间和出院时日常生活能力[日常生活活动量表(ADL)]评分,干预前和干预7d时下肢静脉血流速度,统计并比较两组并发症发生情况,调查患者对护理满意情况。结果:观察组机械通气时间(3.49±0.52)d、ICU住院时间(8.36±2.01)d,均短于对照组的(5.38±1.25)d、(11.56±3.34)d,ADL(47.96±5.21)分高于对照组的(39.87±4.32)分,具有统计学差异(P<0.05);观察组干预7d时股静脉血流速度(27.82±3.25)cm/s、腘静脉血流速度(21.56±2.67)cm/s,均快于对照组的(20.54±3.17)cm/s、(14.96±3.20)cm/s,具有有统计学差异(P<0.05);观察组并发症总发生率为4.55%,低于对照组的18.18%,观察组护理满意度中服务态度(22.59±1.01)分、操作技术(22.47±1.04)分、康复训练(22.49±1.07)分、健康指导(22.52±1.12)分、总分(89.94±5.19)分,均高于对照组的(20.56±2.13)分、(20.58±2.11)分、(20.67±2.05)分、(20.69±2.08)分、(80.53±5.64)分,具有统计学差异(P<0.05)。结论:以护士为主导的早期活动方案能够促进ICU机械通气患者康复,缩短机械通气时间和住院时间,减少并发症发生,促进护理满意度提升。

Objective:To explore the application effect of nurse-led early activity program in patients with mechanical ventilation in intensive care unit(ICU).Methods:88 patients with mechanical ventilation in ICU of a hospital from September 2018 to September 2020 were selected and randomly divided into two groups.The control group(44 cases)was given routine nursing,and the observation group(44 cases)was given nurse-led early activity program.The mechanical ventilation time,ICU hospitalization time,ADL score at discharge,lower extremity venous blood flow velocity before and 7 days after intervention were compared between the two groups.The incidence of complications in the two groups was counted and compared,and the patients'satisfaction with nursing was investigated.Results:The duration of mechanical ventilation(3.49±0.52)d,ICU hospitalization time(8.36±2.01)d in the observation group were shorter than those in the control group[(5.38±1.25)d,(11.56±3.34)d],and the ADL in the observation group[(47.96±5.21)points]was higher than that in the control group[(39.87±4.32)points],with statistical difference(P<0.05).The blood flow velocity of femoral vein and popliteal vein in observation group were(27.82±3.25)cm/s and(21.56±2.67)cm/s on the 7th day of intervention,which were faster than those in control group[(20.54±3.17)cm/s,(14.96±3.20)cm/s],with statistical difference(P<0.05).The total incidence of complications in the observation group was 4.55%,which was lower than 18.18%in the control group.The scores of service attitude,operation technique,rehabilitation training,health guidance and total score in the observation group were(22.59±1.01),(22.47±1.04),(22.49±1.07),(22.52±1.12)and(89.94±5.19),which were higher than(20.56±2.13),(20.58±2.11),(20.67±2.05),(20.69±2.08)and(80.53±5.64)in the control group,and the difference was statistically significant(P<0.05).Conclusion:The nurse-led early activity program can promote the rehabilitation of ICU patients with mechanical ventilation,shorten the duration of mechanical ventilation and hospitalization,reduce the incidence of complications,and promote the improvement of nursing satisfaction.