2种解除约束方案对降低重症监护病房患者重症监护病房获得性衰弱发生率的影响

Effects of Two Unconstrained Schemes on Reducing the Incidence of Acquired Weakness in Patients in Intensive Care Unit

目的比较2种解除约束方案对降低重症监护病房(ICU)患者ICU获得性衰弱(ICU-AW)发生率的影响。方法选取医院2022年1月至2023年6月收治的ICU患者120例,根据解除约束方案的不同分为对照组和观察组,各60例。对照组患者予传统解除约束方案,观察组患者予基于ICU约束决策轮下的解除约束方案,比较临床干预效果。结果观察组患者的ICU-AW发生率、非计划性拔管发生率分别为18.33%和0,分别显著低于对照组的43.33%和11.67%(P<0.05);干预后,两组患者的急性生理与慢性健康评估量表(APACHEⅡ)评分均显著降低(P<0.05),格斯拉昏迷指数量表(GCS)评分均显著升高(P<0.05),且观察组均显著优于对照组(P<0.05);观察组患者的约束时间显著短于对照组(P<0.05);观察组患者的身体约束相关并发症发生率为5.00%,显著低于对照组的25.00%(P<0.05)。结论对ICU患者实施基于ICU约束决策轮下的解除约束方案,能缩短患者的临床约束时间,减少ICU-AW、非计划性拔管、身体约束相关并发症的发生率,改善APACHEⅡ和GCS评分。

Objective To compare the effects of two unconstrained regimens on reducing the incidence of ICU acquired weakness(ICU-AW)in patients in intensive care unit(ICU).Methods A total of 120 ICU patients admitted to the hospital from January 2022 to June 2023 were selected and divided into the control group and the observation group based on different plans for relieving constraints,with 60 cases in each group.The control group was given a traditional unconstrained plan,while the observation group was given a unconstrained plan based on ICU constraint decision-making rounds,and the clinical intervention effects were compared.Results The incidence of ICU-AW and unplanned extubation in the observation group were 18.33% and 0,which were significantly lower than 43.33% and 11.67% in the control group(P<0.05).After intervention,the acute physiological and chronic health assessment scale(APACHEⅡ)scores significantly reduced(P<0.05),and the GCS scores significantly increased in the two groups(P<0.05),and those in the observation group were significantly better than those in the control group(P<0.05).The constraint time in the observation group was significantly shorter than that in the control group(P<005).The incidence of physical constraint related complications in the observation group was 5.00%,which was significantly lower than 25.00% in the control group(P<0.05).Conclusion Implementing a constraint relief plan based on ICU constraint decision-making rounds for ICU patients can shorten their clinical constraint time,reduce the incidence of ICU-AW,unplanned extubation,and complications related to physical constraints,and improve APACHEⅡ and GCS scores.