ICU环境下护士主导的重症患者早期康复的 范围综述

Scoping Review of Nurse-Led Early Rehabilitation for Critically Ill Patients in ICU Environment

摘要: 目的：对ICU环境下护士主导的重症患者早期康复的研究进行范围综述，为重症患者早期康复的临床实践及未来研究提供参考。方法：依据范围综述的研究方法，系统检索PubMed、Web of Science、SBSCO、Embase、The Cochrane Library、中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库中有关ICU环境下护士主导的重症患者早期康复的相关研究，检索时限为建库至2025年7月1日。结果：共纳入15篇文献。ICU环境下重症患者早期康复的主导护士类别有ICU护士、神经科护士及专科护士；早期康复的内容包括体位训练、呼吸训练、运动训练、吞咽训练以及物理治疗；早期康复的时机多从入住ICU 24~48 h介入；早期康复具有安全性和有效性。结论：ICU环境下护士主导的早期康复对重症患者具有积极的效果。然而，目前护士主导的重症患者早期康复只关注短期结局，未来应构建科学化、规范化的早期康复方案，促进重症患者长期结局的改善。

Abstract: Objective: To conduct a scoping review of nurse-led early rehabilitation for critically ill patients in ICU environment, so as to provide a reference for clinical practice and future research on early rehabilitation for critically ill patients. Methods: According to the research methodology of scoping reviews, PubMed, Web of Science, SBSCO, Embase, the Cochrane Library, CNKI, Wanfang Data, VIP Chinese Science and Technology Journal Database, and Chinese Biomedical Literature Database were systematically searched for studies related to nurse-led early rehabilitation management for critically ill patients in ICU environment, and the search period was from the establishment of the databases to July 2025. Results: A total of 15 articles were included. The leading categories of nurses for early rehabilitation of critical patients in the ICU environment include ICU nurses, neurology nurses, and specialized nurses; the content of early rehabilitation includes positioning training, respiratory training, exercise training, swallowing training, and physical therapy; the timing for early rehabilitation often intervenes 24 to 48 hours after admission to the ICU; early rehabilitation has safety and effectiveness. Conclusion: Early rehabilitation led by nurses in the ICU environment has a positive effect on critically ill patients. However, current research on nurse-led early rehabilitation for critically ill patients focuses solely on short-term outcomes. In the future, research should focus on constructing scientific, standardized early rehabilitation management protocols to improve the long-term outcomes of critically ill patients.