早期床上分级运动联合肠内营养对ICU机械通气患者胃肠功能及肌力恢复的影响

Effect of Early Graded Bed Exercise Combined with Enteral Nutrition on Gastrointestinal Function and Muscle Strength Recovery in ICU Mechanically Ventilated Patients

目的:探究早期床上分级运动联合肠内营养对重症监护室(ICU)机械通气患者胃肠功能及肌力恢复的影响。方法:选取2022年5月—2023年5月南平市第一医院收治的ICU机械通气患者90例。按随机数字表法将90例患者分为观察组(45例)及对照组(45例)。对照组给予常规锻炼联合肠内营养治疗,观察组给予早期床上分级运动联合肠内营养。比较两组胃肠功能情况、肌力恢复情况[医学研究委员会肌力评定量表(medical research council scale,MRC)]、自理能力评分、睡眠质量评分[匹兹堡睡眠质量指数量表(PSQI)]、住院相关指标及并发症的发生情况。结果:干预后观察组急性胃肠功能损伤分级情况优于对照组(P<0.05)。干预后两组MRC评分、自理能力评分与干预前相比均提升,且观察组均高于对照组(P<0.05)。干预后两组的PSQI评分与干预前相比均下降,且观察组低于对照组(P<0.05)。观察组干预后机械通气、ICU住院、总住院时间均短于对照组(P<0.05)。观察组并发症总发生率(4.44%)低于对照组(26.67%)(P<0.05)。结论:早期床上分级运动联合肠内营养能够有效改善ICU机械通气患者胃肠功能和肌力,有助于提升其自理能力和睡眠质量,缩短机械通气时间和住院时间,降低并发症的发生率。

Objective:To investigate the effect of early bed graded exercise combined with enteral nutrition on gastrointestinal function and muscle strength in mechanically ventilated patients in the intensive care unit(ICU).Method:A total of 90 ICU mechanical ventilation patients admitted to the Nanping First Hospital from May 2022 to May 2023 were selected.They were divided into the observation group(45 cases)and the control group(45 cases)by random number table method.The control group received routine exercise combined with enteral nutrition treatment,while the observation group received early bed graded exercise combined with enteral nutrition.The gastrointestinal function,muscle strength recovery[medical research council scale(MRC)],self-care ability score,sleep quality score[Pittsburgh sleep quality index(PSQI)],hospitalization related indicators,and incidence of complications between two groups were compared.Result:After intervention,the grading of acute gastrointestinal function injury in the observation group was better than that in the control group(P<0.05).After intervention,the MRC scores and self-care ability scores of both groups improved compared to before intervention,and those in the observation group were higher than those in the control group(P<0.05).After intervention,the PSQI scores of the two groups decreased compared to before intervention,and that in the observation group was lower than that in the control group(P<0.05).After intervention,the mechanical ventilation time,ICU hospitalization time,and total hospital stay in the observation group were shorter than those in the control group(P<0.05).The total incidence of complications in the observation group(4.44%)was lower than that(26.67%)in the control group(P<0.05).Conclusion:Early graded bed exercise combined with enteral nutrition can effectively improve gastrointestinal function and muscle strength in ICU mechanically ventilated patients,help improve their self-care ability and sleep quality,shorten mechanical ventilation time and hospitalization time,and reduce the incidence of complications.