摘要
目的 探讨基于昼夜节律机制的肠内营养干预联合早期运动训练对老年患者术后重症监护病房(ICU)综合征的预防效果。方法 将98例术后住ICU的老年患者随机分为观察组和对照组,各49例。对照组患者给予早期运动训练干预,观察组患者在对照组基础上给予基于昼夜节律机制的肠内营养干预。比较两组患者ICU综合征发生情况[ICU意识模糊评估法(CAM-ICU)评分]、ICU环境压力[ICU环境压力源问卷(ICU-ESQ)评分]、肌力状态[英国医学研究委员会肌力评估量表(MRC)评分]及生活质量[生活质量综合评定问卷(GQOLI-74)评分]。结果 干预后,观察组患者ICU综合征发生率低于对照组(P<0.05)。干预后,两组患者ICU-ESQ自身感受、物理环境、治疗环境及人文环境维度评分较干预前降低,且观察组低于对照组(P<0.01);两组患者MRC评分较干预前升高,且观察组高于对照组(P<0.01);两组患者GQOLI-74心理功能、物质功能、社会功能、躯体功能维度评分较干预前升高,且观察组高于对照组(P<0.01)。结论 基于昼夜节律机制的肠内营养干预联合早期运动训练,对预防老年患者术后ICU综合征的效果较好,值得临床推广。
Objective To investigate the effect of circadian mechanism-based enteral nutrition intervention(ENI)plus early exercise training(EET)preventing postoperative intensive care unit(ICU)syndrome in elderly patients.Methods Ninety-eight elderly patients admitted to ICU after operation were randomly divided into observation and control group,with 49 ones in each.Controls received EET intervention and observation group did circadian mechanism-based ENI on the basis of controls.Such indexes were compared between two groups as the occurrence of ICU syndrome(Confusion Assessment Method for the Intensive Care Unit[CAM-ICU]),ICU environmental stress(Intensive Care Unit Environmental Stressor Questionnaire[ICU-ESQ]),muscle strength status(Medical Research Council Scale for Muscle Strength[MRC])and quality of life(Generic Quality of Life Inventory-74[GQOLI-74]).Results After intervention,the incidence of ICU syndrome was lower in observation than control group(P<0.05).After intervention,self-feeling,physical,treatment and human environment scores of the ICU-ESQ lowered in both groups compared with pre-intervention and those were lower in observation than control groups(P<0.01);MRC scores elevated in both groups and those were higher in observation than control group(P<0.01);psychological,material,social and somatic function scores of the GQOLI-74 elevated in both groups and those were higher in observation than control group(P<0.01).Conclusion Circadian mechanism-based ENI EET plus has a better effect in the prevention of postoperative ICU syndrome in elderly patients and is worthy of clinical promotion.
作者
丁坤华
李婷
卫晓静
景孟娟
Ding Kunhua;Li Ting;Wei Xiaojing;Jing Meng juan(Henan Provincial People's Hospital,Zhengzhou 450000,Henan,China)
出处
《临床心身疾病杂志》
2025年第2期99-103,共5页
Journal of Clinical Psychosomatic Diseases
关键词
肠内营养
昼夜节律机制
早期运动训练
老年患者
重症监护病房综合征
enteral nutrition
circadian rhythm mechanism
early exercise training
elderly patient
intensive care unit syndrome
