[1]庄月娥,黄玲,蔡晶晶,等.早期神经肌肉电刺激联合自制康复床上座椅疗法对机械通气ICU获得性衰弱患者的应用效果[J].中国医学物理学杂志,2023,40(2):220-225.[doi:DOI:10.3969/j.issn.1005-202X.2023.02.016]
　ZHUANG Yuee,HUANG Ling,CAI Jingjing,et al.Therapeutic effect of early neuromuscular electrical stimulation combined with self-made rehabilitation bed chair on ICU-acquired weakness in mechanically ventilated patients[J].Chinese Journal of Medical Physics,2023,40(2):220-225.[doi:DOI:10.3969/j.issn.1005-202X.2023.02.016]
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早期神经肌肉电刺激联合自制康复床上座椅疗法对机械通气ICU获得性衰弱患者的应用效果()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
40卷
期数:
2023年第2期
页码:
220-225
栏目:
医学生物物理
出版日期:
2023-03-03

文章信息/Info

Title:
Therapeutic effect of early neuromuscular electrical stimulation combined with self-made rehabilitation bed chair on ICU-acquired weakness in mechanically ventilated patients
文章编号:
1005-202X（2023）02-0220-06
作者:
庄月娥; 黄玲; 蔡晶晶; 李焕根
福建医科大学附属泉州第一医院重症医学科， 福建 泉州 362000
Author(s):
ZHUANG Yuee;  HUANG Ling;  CAI Jingjing;  LI Huangen
Intensive Care Unit, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China
关键词:
早期神经肌肉电刺激; 自制康复床; 机械通气; 重症监护病房; 获得性衰弱
Keywords:
Keywords: early neuromuscular electrical stimulation self-made rehabilitation bed chair mechanical ventilation intensive care unit acquired weakness
分类号:
R49
DOI:
DOI:10.3969/j.issn.1005-202X.2023.02.016
文献标志码:
A
摘要:
目的：分析早期神经肌肉电刺激（NMES）联合自制康复床上座椅疗法对机械通气ICU获得性衰弱（ICU-AW）患者的应用效果。方法：选择2019年7月到2021年12月在福建医科大学附属泉州市第一医院重症医学科机械通气ICU-AW患者100例。入选患者根据入院先后顺序将2019年7月到2020年8月进行机械通气ICU-AW患者分为对照组（n=50），采用常规康复护理结合NMES疗法，将2020年9月到2021年12月进行机械通气ICU-AW患者分为研究组（n=50），在对照组的基础上联合康复床上座椅疗法。在治疗期间观察与记录两组患者的医学研究理事会（MRC）评分、ICU-AW患病率，统计机械通气时间、入住ICU时间、总住院时间、血液流变学指标以及护理满意度情况。结果：第5、10天时，对照组的MRC总评分、上肢与下肢评分明显低于第1天时（P<0.05），而研究组第10天时以上评分低于第1天（P<0.05）。第1天时，两组的MRC总评分、上肢与下肢评分比较，差异无统计学差异（P>0.05）；第5、10天时，研究组MRC总评分、上肢与下肢评分均明显高于对照组（P<0.05）。第1天时，两组的ICU-AW患病率与ICU谵妄比较，差异无统计学差异（P>0.05）；第5、10天时，研究组ICU-AW患病率与ICU谵妄均明显低于对照组（P<0.05）。第10天，两组血液流变学指标高剪切粘度、血浆粘度、全血低剪切粘度和红细胞聚集均较第1天时明显减小（P<0.05），且研究组血液流变学指标均明显低于对照组（P<0.05）。研究组的机械通气时间、首次下床时间、入住ICU时间、总住院时间均短于对照组（P<0.05）。出院时，研究组的满意度为96.00%，明显高于对照组的80.00%（P<0.05）。结论：NMES联合自制康复床上座椅疗法干预机械通气ICU-AW患者，可以有效提高MRC评分与肌力，降低ICU-AW患病率与ICU谵妄发生率，缩短机械通气时间、首次下床时间、入住ICU时间、总住院时间，改善血液流变学指标，提高满意度，值得临床推广。
Abstract:
Abstract: Objective To analyze the effect of early neuromuscular electrical stimulation (NMES) combined with self-made rehabilitation bed chair to treat intensive care unit-acquired weakness (ICU-AW) in mechanically ventilated patients. Methods A total of 100 mechanically ventilated ICU-AW patients treated in the Intensive Care Unit, Quanzhou First Hospital Affiliated to Fujian Medical University from July 2019 to December 2021 were enrolled in the study. The ICU-AW patients who underwent mechanical ventilation from July 2019 to August 2020 were classified into control group (n=50) for routine rehabilitation nursing combined with NMES, and besides those treatment of control group, rehabilitation bed chair was adopted for those in study group (n=50) who were treated with mechanical ventilation from September 2020 to December 2021. During the treatment, the Medical Research Council (MRC) score, ICU-AW prevalence rate, duration of mechanical ventilation, lengths of ICU stay and hospital stay, blood rheological parameters and nursing satisfaction were recorded. Results The total MRC score, upper and lower extremity MRC scores of control group on the 5th and 10th days were significantly lower than those on the 1st day (P<0.05), while in study group, until day 10, the above scores were lower than those on the 1st day (P<0.05). On the 1st day, there was no statistical difference between two groups in total MRC score, upper and lower extremity MRC scores, ICU-AW prevalence rate and incidence of ICU delirium (P>0.05). However, on days 5 and 10, compared with control group, study group had significantly higher total MRC score, upper and lower limb scores, and lower incidences of ICU-AW and ICU delirium (P<0.05). On day 10, the high-shear viscosity, plasma viscosity, whole blood low-shear viscosity and EA in two groups were significantly decreased (P<0.05), and those in study group were significantly lower than those in control group (P<0.05). The duration of mechanical ventilation, time to the first out-of-bed, ICU stay, and total hospital stay were shorter in study group than control group (P<0.05). At discharge, the satisfactions with nursing in study group and control group were 96.00% and 80.00% (P<0.05). Conclusion NMES combined with self-made rehabilitation bed chair to intervene ICU-AW patients in mechanical ventilation is worthy of clinical promotion for it can effectively improve MRC score and muscle strength, reduce the prevalence of ICU-AW and the incidence of ICU delirium, shorten the duration of mechanical ventilation, time to the first out-of-bed, ICU stay and hospital stay, and improve blood rheological parameters and satisfaction degree.

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备注/Memo

备注/Memo:
【收稿日期】2022-09-25 【基金项目】福建省自然科学基金（2019J01597） 【作者简介】庄月娥，副主任护师，研究方向：重症康复护理，E-mail: mixue0026@163.com 【通信作者】李焕根，副主任医师，研究方向：腹部重症、重症康复，E-mail: 345875567@qq.com
更新日期/Last Update: 2023-03-03