早期活动联合基于指南的早期营养对ICU患者的影响

Effect of Early Activities Combined with Early Nutrition Based on Guidelines on ICU Patients

目的:探究早期活动联合基于指南的早期营养对重症监护室(intensive care unit,ICU)患者的影响。方法:选取2020年9月—2022年9月苏州大学附属第一医院收治的108例ICU患者,根据随机数表法将其分为对照组与研究组,各54例。对照组接受常规护理,研究组在此基础上接受早期活动联合基于指南的早期营养。比较两组干预前后肌力情况、运动功能、日常生活活动能力,相关指标及并发症。结果:干预后,两组医学研究委员会(Medical Research Council,MRC)评分低于干预前,Fugl-Meyer评分高于干预前,且研究组MRC评分、Fugl-Meyer评分均高于对照组,差异有统计学意义(P<0.05)。研究组ICU获得性虚弱(ICU-acquired weakness,ICU-AW)发生率低于对照组,ICU住院时间及总住院时间均短于对照组,差异有统计学意义(P<0.05)。干预后,研究组日常生活活动能力分级优于干预前及对照组,差异有统计学意义(P<0.05)。研究组ICU期间并发症发生率为3.70%,低于对照组的14.81%,差异有统计学意义(P<0.05)。结论:早期活动联合基于指南的早期营养对ICU患者ICU-AW具有防治作用,可缩短患者住院时间,改善其运动功能。

Objective:To explore the effect of early activities combined with early nutrition based on guidelines on intensive care unit(ICU)patients.Method:A total of 108 ICU patients who admitted to the First Affiliated Hospital of Soochow University from September 2020 to September 2022 were selected.According to the random number table method,they were divided into control group and study group,54 cases in each group.The control group was given routine care,while the study group was given early activities combined with early nutrition based on guidelines on this basis.The muscle strength condition,motor function,activities ability of daily living before and after intervention,related indexes and complications were compared between the two groups.Result:After the intervention,the Medical Research Council(MRC)scores of the two groups were lower than those before the intervention,and the Fugl-Meyer scores were higher than those before the intervention,and the MRC score and Fugl-Meyer score of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of ICU-acquired weakness(ICU-AW)in the study group was lower than that in the control group,and the ICU hospital stay and total hospital stay in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After the intervention,the activities ability of daily living classification in the study group was better than that before the intervention and the control group,and the differences were statistically significant(P<0.05).The incidence of complications during ICU in the study group was 3.70%,which was lower than 14.81%in the control group,and the difference was statistically significant(P<0.05).Conclusion:The combination of early activities and early nutrition based on guidelines has preventive and therapeutic effects on ICU patients with ICU-AW,which can shorten the hospital stay and improve their motor function.