早期运动护理干预对ICU机械通气患者获得性衰弱的作用研究

Study on the Effect of Early Exercise Nursing Intervention on Acquired Weakness in ICU Patients with Mechanical Ventilation

摘要: 目的：构建并实施ICU机械通气患者早期运动护理干预方案，探讨该方案对ICU获得性衰弱发生率、肌力、生活自理能力及相关临床结局的影响，并分析其安全性。方法：采用类实验研究设计，选取某三级甲等医院综合ICU机械通气患者为研究对象，按1:1比例分为干预组和对照组。两组患者均给予ICU常规护理，干预组在此基础上实施基于目标导向理论和ABCDEF集束化策略的早期运动护理干预方案，干预持续7 d。比较两组患者ICU-AW发生率、肌力、生活自理能力、机械通气时间及ICU住院时间的差异，并监测干预过程中的生命体征及不良事件。结果：最终纳入完成研究的患者共81例。两组患者在一般资料及基线指标方面差异均无统计学意义。干预后，干预组ICU-AW发生率低于对照组，肌力评分和Barthel指数均高于对照组，机械通气时间及ICU住院时间短于对照组，差异具有统计学意义。干预过程中未发生严重不良事件，患者生命体征总体稳定。结论：早期运动护理干预可降低ICU机械通气患者ICU-AW的发生率，改善肌力和生活自理能力，并有助于缩短机械通气及ICU住院时间，具有较好的安全性。

Abstract: Objective: To construct and implement the early exercise nursing intervention program for ICU patients with mechanical ventilation, to explore the effect of this program on the incidence of ICU acquired weakness, muscle strength, self-care ability and related clinical outcomes, and to analyze its safety. Methods: A quasi-experimental study design was used to select patients with mechanical ventilation in a comprehensive ICU of a tertiary-level Class A hospital as the research object, and they were divided into intervention group and control group according to the ratio of 1:1. Both groups were given ICU routine nursing. On this basis, the intervention group implemented an early exercise nursing intervention program based on goal-oriented theory and ABCDEF clustering strategy, and the intervention lasted for 7 days. The incidence of ICU-AW, muscle strength, self-care ability, mechanical ventilation time and ICU hospitalization time were compared between the two groups, and the vital signs and adverse events during the intervention were monitored. Results: A total of 81 patients completed the study. There was no significant difference in general data and baseline indicators between the two groups. After intervention, the incidence of ICU-AW in the intervention group was lower than that in the control group, the muscle strength score and Barthel index were higher than those in the control group, the mechanical ventilation time and ICU hospitalization time were shorter than those in the control group, and the differences were statistically significant. No serious adverse events occurred during the intervention, and the patient’s vital signs were generally stable. Conclusion: Early exercise nursing intervention can reduce the incidence of ICU-AW in ICU patients with mechanical ventilation, improve muscle strength and self-care ability, and help to shorten the mechanical ventilation and ICU hospitalization time, with good safety.