进阶式早期康复训练对RICU机械通气患者成功撤机及肺功能的影响

Effect of advanced early rehabilitation training on successful weaning and lung function of RICU patients with mechanical ventilation

目的研究进阶式早期康复训练对呼吸重症监护病房(RICU)机械通气患者成功撤机及肺功能的影响。方法选取2020年1月至2021年12月该院收治的RICU机械通气患者106例作为研究对象,采用电脑编号随机法分为A组和B组,每组53例。B组实施常规护理,A组则于常规护理基础上增用进阶式早期康复训练。对比2组患者呼吸机依赖率、成功撤机率、机械通气时间、入RICU时间、呼吸力学指标、氧合指标、功能独立性等。结果A组患者呼吸机依赖率[33.96%(18/53)]明显低于B组[58.49%(31/53)],成功撤机率明显高于B组,机械通气时间、入RICU时间均明显短于B组,差异均有统计学意义(P<0.05)。2组患者出RICU时平均气道压、气道峰压均明显低于入RICU时,动态顺应性,以及运动、认知评分均明显高于入RICU时,各项氧合指标均较入RICU时明显改善,且A组患者出RICU时平均气道压、气道峰压均明显低于B组,动态顺应性,以及运动、认知评分均明显高于B组,各项氧合指标改善程度均明显优于B组,差异均有统计学意义(P<0.05)。结论进阶式早期康复训练可提高RICU机械通气患者成功撤机率,有利于肺功能及功能独立性的改善。

Objective To study the effect of advanced early rehabilitation training on successful weaning and lung function of patients with mechanical ventilation in respiratory intensive care unit(RICU).Methods A total of 106 RICU patients with mechanical ventilation admitted to the hospital from January 2020 to December 2021 were selected as the study objects.They were randomly divided into group A(n=53)and group B(n=53)by computer numbering method.Group B received routine nursing,while group A received advanced early rehabilitation training on the basis of group B.The ventilator dependence rate,successful weaning probability,mechanical ventilation time,hospital stay of RICU,respiratory mechanics index,oxygenation index and functional independence were compared between the two groups.Results The rate of ventilator dependence in group A[33.96%(18/53)]was lower than that in group B[58.49%(31/53)],the probability of successful weaning was higher than that in group B,and the mechanical ventilation time and hospital stay of RICU were shorter than those in group B,with statistical significance(P<0.05).The mean airway pressure and peak airway pressure when leaving RICU in both groups were lower than those when entering ICU,and the dynamic compliance,exercise and cognitive scores were significantly higher than those when entering RICU,and all oxygenation indexes were significantly improved.Moreover,the mean airway pressure and peak airway pressure of the patients in group A were significantly lower than those in group B,and the dynamic compliance,exercise and cognitive scores were significantly higher than those in group B,and the improvement degree of various oxygenation indexes was significantly better than that in group B,with statistical significance(P<0.05).Conclusion Advanced early rehabilitation training can improve the probability of successful weaning in patients with RICU mechanical ventilation,and is beneficial to the improvement of lung function and functional independence.