ICU机械通气依赖患者模块化干预构建与临床实证-《中国医学物理学杂志》

文章信息/Info

Title:: Construction and clinical empirical study of modular intervention for mechanical ventilation-dependent patients in ICU

Author(s):: HE Yin; HAN Zunhai; GAI Tiantian; LU Zhenhui; YIN Ying; SHI Ying; Intensive Care Unit, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China

Keywords:: Keywords: intensive care unit mechanical ventilation-dependent modular intervention routine intervention weaning success rate

摘要:: 目的：探究重症监护室（ICU）机械通气依赖患者模块化干预构建与临床实证。方法：选取100例ICU机械通气依赖患者，根据入院顺序分为两组，各50例。对照组采取常规干预，观察组在对照组基础上采取模块化干预。统计两组脱机成功率、脱机时间、并发症、康复指标及干预前后血气分析指标、心理状态、营养状况。结果：（1）与对照组比较，观察组脱机成功率高，脱机时间、ICU入住时间、普通病房入院时间短，并发症发生率低（P<0.05）；（2）干预后观察组动脉血二氧化碳分压较对照组低，动脉血氧分压、动脉血氧分压/吸入氧浓度较对照组高（P<0.05）；（3）干预后观察组焦虑自评量表、抑郁自评量表、APACHEⅡ评分较对照组低（P<0.05）；（4）干预后观察组血清总蛋白、血白蛋白、前蛋白、转铁蛋白水平较对照组高（P<0.05）。结论：模块化干预应用于ICU机械通气依赖患者，可提高脱机成功率，改善血气指标及营养状况，缓解负面情绪，减少并发症，缩短康复进程。

Abstract:: Abstract: Objective To explore the construction of modular intervention for patients dependent on mechanical ventilation in ICU, and to conduct the clinical empirical study. Methods A total of 100 mechanical ventilation-dependent patients in ICU were enrolled and divided into two groups according to the admission order, with 50 patients in each group. Control group received routine intervention, while observation group was treated with modular intervention in addition to the treatment given to control group. The weaning success rate, weaning time, complications, rehabilitation index, blood gas analysis index, psychological state, and nutritional status were compared between two groups. Results Compared with control group, observation group had higher weaning success rate, shorter weaning time, ICU stay and general ward admission, and lower incidence of complications (P<0.05). After intervention, observation group had lower PaCO2, and higher PaO2 and PaO2/FiO2 than control group (P<0.05) the scores of SAS, SDS and APACHEⅡ were lower in observation group than in control group (P<0.05) and the serum levels of ALB, PA, TRF and TP in observation group were higher than those in control group (P<0.05). Conclusion Modular intervention for mechanical ventilation-dependent patients in ICU can increase weaning success rate, improve blood gas analysis index and nutritional status, alleviate negative emotions, reduce complications and speed recovery.