以音乐治疗为核心的系统化康复干预模式在重症肺炎患者中的应用

Application of Systematic Rehabilitation Intervention Model Centered on Music Therapy in Patients with Severe Pneumonia

目的:探讨以音乐治疗为核心的系统化康复干预模式在重症肺炎患者中的应用效果。方法:选择2020年3月1日~2021年5月31日重症医学科收治的60例重症肺炎患者,根据随机数字表法分为研究组和对照组各30例,对照组接受常规护理,研究组在常规护理基础上实施以音乐治疗为核心的系统化康复干预,两组均干预7 d;比较两组干预前、干预7 d后病情进展[采用系统急性生理学及慢性健康状况评分系统(APACHEⅡ)]、心理状态[采用焦虑自评量表(SAS)、抑郁自评量表(SDS)]、睡眠质量[采用匹兹堡睡眠质量指数(PSQI)]、免疫功能[包括全血CD4^(+)CD25^(+)Treg、CD8^(+)CD28^(-)Treg]、炎症反应[包括血清肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)],干预期间谵妄发生情况。结果:干预7 d后,两组APACHEⅡ、SAS、SDS、PSQI评分均低于对照组(P<0.05),且研究组低于对照组(P<0.05);干预7 d后,两组TNF-α、IL-10水平均低于干预前(P<0.05),且研究组低于对照组(P<0.05);干预7 d后,两组全血CD4^(+)CD25^(+)Treg、CD8^(+)CD28^(-)Treg均高于干预前(P<0.05),且研究组高于对照组(P<0.05);干预期间,研究组谵妄发生率低于对照组(P<0.05)。结论:以音乐治疗为核心的系统化康复干预模式可改善重症肺炎患者病情、心理状态和睡眠质量,提高免疫功能,抑制炎症反应,同时降低谵妄的发生率。

Objective:To explore the application effect of systematic rehabilitation intervention model centered on music therapy in patients with severe pneumonia.Methods:A total of 60 patients with severe pneumonia admitted during March 1,2020 to May 31,2021 were selected as the research objects,and were divided into the study group and the control group each with 30 cases by the random number table method.The control group received routine nursing care,and the study group received systematic rehabilitation intervention model centered on music therapy on the basis of the control group,both groups received intervention for 7 days.The disease progression by acute physiology and chronic health evaluation scoring system(APACHEⅡ),mental state by self-rating anxiety scale(SAS)and self-rating depression scale(SDS),sleep quality by Pittsburgh sleep quality index(PSQI),immune function by CD4^(+)CD25^(+)Treg and CD8^(+)CD28^(-)Treg and inflammatory response by tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)before intervention and after 7 days of intervention,and the occurrence of delirium during the intervention period were compared between the two groups.Results:After the intervention,the scores of APACHEⅡ,SAS,SDS and PSQI in the two groups were lower than those before intervention(P<0.05),and those in the study group were lower than those in the control group(P<0.05).The serum levels of TNF-αand IL-10 after 7 days of intervention in the two groups were lower than those before intervention(P<0.05).Those in the study group were lower than those in the control group(P<0.05).The whole blood levels of CD4^(+)CD25^(+)Treg and CD8^(+)CD28^(-)Treg after 7 days of intervention in the two groups were higher than those before intervention(P<0.05),and those in the study group were higher than those in the control group(P<0.05).During the intervention period,the incidence of delirium in the study group was lower than that in the control group(P<0.05).Conclusion:The systematic rehabilitation intervention model centered on music therapy can improve the disease progression,mental state and sleep quality in patients with severe pneumonia,enhance immune function,suppress inflammation,and reduce the incidence of delirium.