早期康复训练用于ICU重症肺炎机械通气患者的效果观察

Effect observation of early rehabilitation training on mechanically ventilated patients with severe pneumonia in ICU

目的 观察早期康复训练用于重症加强护理病房(ICU)重症肺炎机械通气患者的临床效果。方法 130例ICU重症肺炎机械通气患者,依据康复护理方法不同分为研究组与对照组,各65例。对照组采用常规康复护理,研究组采用早期康复训练。比较两组护理前后血气指标[动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、血清降钙素原(PCT)、急性生理与慢性健康评分表(APACHEⅡ)评分、患者机械通气时间、抗生素使用时间、症状缓解时间、ICU住院时间及康复效果。结果 护理后,两组SaO_(2)、PaO_(2)均高于本组护理前,且研究组SaO_(2)(99.06±1.36)%、PaO_(2)(94.87±3.18)mm Hg (1 mm Hg=0.133 kPa)高于对照组的(90.64±1.48)%、(87.60±5.20)mm Hg。两组PaCO_(2)、血清PCT及APACHEⅡ评分均低于本组护理前,且研究组PaCO_(2)(35.72±4.51)mm Hg、血清PCT(4.27±1.06)ng/ml及APACHEⅡ评分(14.71±3.86)分低于对照组的(43.05±5.96)mm Hg、(6.61±1.96)ng/ml及(20.97±4.34)分,差异均有统计学意义(P<0.05)。研究组患者机械通气时间(3.53±0.99)d、抗生素使用时间(5.22±1.15)d、症状缓解时间(4.53±0.75)d及ICU住院时间(11.48±2.36)d均显著短于对照组的(6.97±1.15)、(6.76±1.37)、(8.37±1.34)、(15.19±3.28)d,差异均有统计学意义(P<0.05)。研究组康复总有效率98.46%显著高于对照组的87.69%,差异有统计学意义(P<0.05)。结论 在ICU重症肺炎机械通气患者中,实施早期康复训练,可显著改善患者血气指标,降低血清炎症指标,改善APACHEⅡ评分,缩短机械通气时间、抗生素使用时间、症状缓解时间及ICU住院时间,提升康复效果。

Objective To observe the clinical effect of early rehabilitation training on mechanically ventilated patients with severe pneumonia in intensive care unit(ICU).Methods A total of 130 mechanically ventilated patients with severe pneumonia in ICU were divided into a research group and a control group according to different rehabilitation nursing methods,with 65 cases in each group.The control group used conventional rehabilitation nursing,and the research group used early rehabilitation training.Both groups were compared in terms of blood gas indexes [arterial oxygen saturation(SaO_(2)),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],serum PCT,acute physiological and chronic health evaluation Ⅱ(APACHE Ⅱ) score before and after nursing,duration of mechanical ventilation,duration of antibiotic use,symptom relief time,duration of ICU stay and rehabilitation effect.Results After nursing,the SaO_(2) and PaO_(2) in both groups were higher than those before nursing in this group,and the research group had SaO_(2) of(99.06±1.36)% and PaO_(2) of(94.87±3.18) mm Hg(1 mm Hg=0.133 kPa),which were higher than(90.64±1.48)% and(87.60±5.20) mm Hg in the control group.TheCC PaCO_(2),serum procalcitonin(PCT) and APACHE Ⅱ scores in both groups were lower than those before nursing in this group;the research group had PaCO_(2) of(35.72±4.51) mm Hg,serum PCT of(4.27±1.06) ng/ml and APACHE II score of(14.71±3.86) points,which were lower than(43.05±5.96) mm Hg,(6.61±1.96) ng/ml and(20.97±4.34) in the control group;the differences were all statistically significant(P<0.05).The research group duration of mechanical ventilation of(3.53±0.99) d,duratiAon of antibiotic use of(5.22±1.15) d,symptom relief time of(4.53±0.75) d and duration of ICU stay of(11.48±2.36) d,which were significantly shorter than(6.97±1.15),(6.76±1.37),(8.37±1.34) and(15.19±3.28) d in the control group;all differences were statistically significant(P<0.05).The total effective rate of rehabilitation in the research group was 98.46%,which was significantly higher than 87.69% in the control group,and the difference was statistically significant(P<0.05).Conclusion For mechanically ventilated patients with severe pneumonia in ICU,early rehabilitation training can significantly improve blood gas index,reduce serum inflammation index,improve APACHE Ⅱ score,shorten duration of mechanical ventilation,duration of antibiotic use,symptom relief time and duration of ICU stay of patients,and improve their rehabilitation effect.