摘要
目的:探讨中医护理在预防机械通气患者发生重症监护病房获得性衰弱的应用效果。方法:选取2018年7月-2019年7月河北省沧州中西医结合医院重症监护病房收治的符合入选标准的机械通气患者60例,随机分为观察组和对照组各30例,对照组患者按照专科疾病护理常规开展常规护理工作,包括生命体征监测、加强血糖监测及气道护理、加强心理护理及早期营养支持、监测睡眠质量、翻身拍背、肢体被动活动、肢体功能位摆放等。观察组患者在常规护理基础上采取中医护理措施耳穴埋豆及手指点穴进行干预。观察两组患者干预后的医学研究理事会肌力评分及巴氏指数评分、重症监护病房获得性衰弱发生率,重症监护病房住院时间、机械通气时间、压力性损伤发生率、深静脉血栓发生率、呼吸机相关性肺炎发生情况及患者满意度。结果:干预前两组患者医学研究理事会肌力评分及巴氏指数评分无统计学意义(P> 0.05),干预后观察组两项评分均显著高于对照组,差异有统计学意义(P <0.05),对两组患者机械通气时间和重症监护病房住院时间进行比较,观察组患者机械通气时间和重症监护病房住院时间低于对照组(P <0.05),比较两组患者满意度调查结果显示,观察组满意率优于对照组,差异有统计学意义(P <0.05)。两组患者深静脉血栓、压力性损伤发生率进行比较,观察组发生率低于对照组。两组患者重症监护病房获得性衰弱及呼吸机相关性肺炎发生率比较,观察组发生率明显低于对照组,差异有统计学意义(P <0.05)。结论:中医护理措施可以提高机械通气患者肌力和自理能力,减少重症监护病房获得性衰弱的发生,缩短重症监护病房住院时间,有利于重症患者早期康复。
Objective: To explore the effect of TCM nursing on preventing mechanically ventilated patients with ICU acquired weakness. Methods: From July 2018 to July 2019 60 cases were divided into two groups, with 30 patients in each group. The control group received routine nursing work according to specialized disease nursing routines, including vital signs monitoring, blood glucose monitoring and airway nursing, psychological nursing and early nutritional support, monitoring sleep quality, turning over and patting the back, passive activity of limbs, functional position of limbs, etc.. The observation group received TCM nursing measures of ear acupoints beans burying and intervention at finger points on the basis of routine nursing. Medical Research Council(MRC) muscle strength score and Barthel index score, ICU-AW incidence, ICU stay, mechanical ventilation duration, pressure injury incidence, deep vein thrombosis, ventilator associated pneumonia incidence and patient satisfaction were observed after intervention in the two groups.Results: The MRC muscle strength score and Barthel index score in the two groups were not statistically significant before intervention(P>0.05), and the two scores of the observation group were significantly higher than those in the control group after intervention(P<0.05).The mechanical ventilation time and ICU stay time in the two groups were compared, and the observation group’s mechanical ventilation time and ICU stay time were lower than those in the control group(P<0.05). Comparison of the satisfaction survey results between the two groups showed that the satisfaction rate in the observation group was better than that in the control group, which was with statistically significant difference(P<0.05). The incidence of deep vein thrombosis and pressure injury was compared between the two groups, and the incidence in the observation group was lower than that in the control group. The incidence of ICU-AW and ventilator associated pneumonia was compared between the two groups, the incidence was significantly lower in the observation group than that in the control group, which was with statistically significant difference(P<0.05). Conclusion: TCM nursing measures can improve muscle strength and self-care ability of patients with mechanical ventilation, reduce the occurrence of ICU-AW, shorten the length of stay in ICU, and benefit the early recovery of patients with severe diseases.
出处
《中医临床研究》
2021年第33期6-11,共6页
Clinical Journal Of Chinese Medicine
