早期活动标准化流程应用于外科重症监护病房机械通气危重症患者的效果分析

Effect Analysis of Early Activity Standardization Process Applied to Critically Ill Patients with Mechanical Ventilation in Surgical Intensive Care Unit

目的探讨早期活动标准化流程应用于外科重症监护病房机械通气危重症患者的临床效果。方法选取2020年3~12月深圳市萨米国际医疗中心外科重症监护病房收治的手术后机械通气患者68例,随机分为对照组(常规功能锻炼,n=34),观察组(早期活动标准化流程,n=34)。比较两组患者ICU获得性肌无力(ICU-AW)发生率,术后谵妄发生率,气管导管意外拔管、引流管脱落,机械通气时间、ICU住院时间。结果观察组患者在干预5d、7d后其ICU-AW发生率均低于对照组(P<0.05);观察组患者在干预1d、3d、5d、7d后其谵妄发生率均低于对照组(P<0.05);观察组患者气管导管意外拔管、引流管脱落发生率低于对照组(P<0.05);观察组患者机械通气时间、ICU住院时间短于对照组(P<0.05)。结论早期活动标准化流程可降低外科ICU机械通气患者ICU-AW、谵妄的发生,有效避免护理不良事件的产生,并改善预后。

Objective To investigate the clinical effect of early activity standardization process applied to critically ill patients with mechanical ventilation in surgical intensive care unit.Methods 68 patients with mechanical ventilation after surgery in surgical intensive care unit of Shenzhen Sami International Medical Center from March 2020 to December 2020 were randomly divided into control group(routine functional exercise,n=34)and observation group(standardized process of early activities,n=34).The incidence of ICU-acquired myasthenia(ICU-AW),postoperative delirium,accidental tracheal tube extubation,drainage tube detachment,duration of mechanical ventilation,and length of ICU stay were compared between the two groups.Results The incidence of ICU-AW in the observation group was lower than that in the control group after 5 and 7 days of intervention(P<0.05);the incidence of delirium in the observation group was lower than that in the control group after 1,3,5 and 7 days of intervention(P<0.05);the incidence of accidental tracheal tube extubation and drainage tube shedding in the observation group was lower than that in the control group(P<0.05);the duration of mechanical ventilation and ICU hospitalization in the observation group were shorter than those in the control group(P<0.05).Conclusion The standardized process of early activity can reduce the occurrence of ICU-AW and delirium in patients with mechanical ventilation in surgical ICU,effectively avoid the occurrence of adverse nursing events,and improve the prognosis.