中医按摩配合早期运动用于ICU机械通气 患者的临床疗效研究(1)
〔摘要〕 目的 研究中医按摩配合早期运动用于重症监护室(ICU)机械通气患者的临床疗效。方法 纳入52例接受ICU机械通气治疗的患者作为研究对象，随机抽签分为观察组和对照组，每组各26例。两组ICU住院期间均行常规护理干预，观察组在常规护理基础上行中医按摩配合早期运动训练。比较两组转出ICU时肌力、患者生活自理能力及胃肠功能恢复情况。结果 住院期间两组均未发生死亡病例，观察组患者离开ICU时英国医学研究理事会(MRC)肌力分级和总体生活自理能力均优于对照组，差异有统计学意义(P<0.05)。观察组急性胃肠损伤(AGI)分级优于对照组，差异有统计学意义(P<0.05)。结论 中医按摩配合早期运动训练用于机械通气患者能显著改善肌力和生活自理能力，有助于胃肠功能恢复。
〔关键词〕 中医按摩；早期运动；ICU；机械通气
〔中图分类号〕R247.9 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2018.05.017
Effect of Chinese Medicine Massage Combined with Early Exercise on
Patients with ICU Mechanical Ventilation
WANG Ke， XU Yi*， ZHANG Yan
(Department of Neurosurgery， Emergency Center of Chongqing， Chongqing 400000， China)
〔Abstract〕 Objective To study the effect of Chinese medicine massage combined with early exercise on patients with ICU mechanical ventilation. Methods The 52 patients received the ICU mechanical ventilation were included in the study. They were randomly divided into the observation group and control group， 26 cases in each group. The routine nursing intervention was performed in the two groups during ICU in hospital. The observation group was given Chinese medicine massage combined with early exercise on the basis of routine nursing intervention. The ICU muscle strength， patient's self-care ability and the recovery of gastrointestinal function of the two groups were compared after turning out of ICU. Results There were no deaths in the two groups during hospitalization. The MRC muscle strength classification and the overall self-care ability of the observation group were better than the control group after leaving ICU， the differences were statistically significant (P<0.05). The AGI classification in observation group was better than that of the control group， the difference was statistically significant (P<0.05). Conclusion The Chinese medicine massage combined with early exercise training could significantly improve the ability of muscle strength and self-care in patients with mechanical ventilation， and it could help to recover the gastrointestinal function.
〔Keywords〕 Chinese medicine massage； early exercise； ICU； mechanical ventilation
機械通气是重症监护室(intensive care unit，ICU)患者生命支持的重要方法，对改善临床预后具有重要意义，已广泛应用于临床[1-2]。但近年来报道显示机械通气患者因长期卧床，造成骨骼肌肉萎缩和胃肠功能障碍，已成为影响患者治疗后生活质量的重要原因[3]。早期运动干预和中医按摩有助于促进胃肠功能恢复，改善肌肉萎缩，但目前临床尚缺乏统一的中医按摩和早期运动干预方案[4-5]。本研究纳入52例接受机械通气的ICU患者作为研究对象，探讨中医按摩和早期运动干预的疗效。现报道如下。
1 资料与方法
1.1 一般资料
纳入2016年12月至2017年11月本院52例ICU机械通气患者作为研究对象，纳入标准：(1)24 h≤接受ICU内机械通气治疗<48 h；(2)患者或家属签署知情同意书；(3)此次研究经我院伦理委员会批准；(4)所有患者均≥18岁。排除标准：(1)合并有机械性肠梗阻或胃肠溃疡出血者；(2)既往有精神病史者；(3)肝肾功能严重不全者；(4)入院时已合并有下肢静脉血栓、下肢关节炎及肌肉萎缩者。随机抽签将患者分为两组，每组各26例。观察组男15例，女11例；年龄(52.28±15.61)岁；BMI(20.37±2.24)kg/m2；原发病：肺部感染7例，脑梗死9例，低钾血症6例，腹膜炎4例；急性生理与慢性健康评分(APACHEⅡ评分)(18.21±5.09)分。对照组男17例，女9例；年龄(51.94±14.87)岁；BMI(20.66±2.15)kg/m2；原发病：肺部感染10例，脑梗死8例，低钾血症5例，腹膜炎3例；APACHEⅡ评分(17.74±4.82)分。两组患者性别、年龄、BMI、原发病及APACHEⅡ评分差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(王科 许毅 张艳)
〔关键词〕 中医按摩；早期运动；ICU；机械通气
〔中图分类号〕R247.9 〔文献标志码〕B 〔文章编号〕doi：10.3969/j.issn.1674-070X.2018.05.017
Effect of Chinese Medicine Massage Combined with Early Exercise on
Patients with ICU Mechanical Ventilation
WANG Ke， XU Yi*， ZHANG Yan
(Department of Neurosurgery， Emergency Center of Chongqing， Chongqing 400000， China)
〔Abstract〕 Objective To study the effect of Chinese medicine massage combined with early exercise on patients with ICU mechanical ventilation. Methods The 52 patients received the ICU mechanical ventilation were included in the study. They were randomly divided into the observation group and control group， 26 cases in each group. The routine nursing intervention was performed in the two groups during ICU in hospital. The observation group was given Chinese medicine massage combined with early exercise on the basis of routine nursing intervention. The ICU muscle strength， patient's self-care ability and the recovery of gastrointestinal function of the two groups were compared after turning out of ICU. Results There were no deaths in the two groups during hospitalization. The MRC muscle strength classification and the overall self-care ability of the observation group were better than the control group after leaving ICU， the differences were statistically significant (P<0.05). The AGI classification in observation group was better than that of the control group， the difference was statistically significant (P<0.05). Conclusion The Chinese medicine massage combined with early exercise training could significantly improve the ability of muscle strength and self-care in patients with mechanical ventilation， and it could help to recover the gastrointestinal function.
〔Keywords〕 Chinese medicine massage； early exercise； ICU； mechanical ventilation
機械通气是重症监护室(intensive care unit，ICU)患者生命支持的重要方法，对改善临床预后具有重要意义，已广泛应用于临床[1-2]。但近年来报道显示机械通气患者因长期卧床，造成骨骼肌肉萎缩和胃肠功能障碍，已成为影响患者治疗后生活质量的重要原因[3]。早期运动干预和中医按摩有助于促进胃肠功能恢复，改善肌肉萎缩，但目前临床尚缺乏统一的中医按摩和早期运动干预方案[4-5]。本研究纳入52例接受机械通气的ICU患者作为研究对象，探讨中医按摩和早期运动干预的疗效。现报道如下。
1 资料与方法
1.1 一般资料
纳入2016年12月至2017年11月本院52例ICU机械通气患者作为研究对象，纳入标准：(1)24 h≤接受ICU内机械通气治疗<48 h；(2)患者或家属签署知情同意书；(3)此次研究经我院伦理委员会批准；(4)所有患者均≥18岁。排除标准：(1)合并有机械性肠梗阻或胃肠溃疡出血者；(2)既往有精神病史者；(3)肝肾功能严重不全者；(4)入院时已合并有下肢静脉血栓、下肢关节炎及肌肉萎缩者。随机抽签将患者分为两组，每组各26例。观察组男15例，女11例；年龄(52.28±15.61)岁；BMI(20.37±2.24)kg/m2；原发病：肺部感染7例，脑梗死9例，低钾血症6例，腹膜炎4例；急性生理与慢性健康评分(APACHEⅡ评分)(18.21±5.09)分。对照组男17例，女9例；年龄(51.94±14.87)岁；BMI(20.66±2.15)kg/m2；原发病：肺部感染10例，脑梗死8例，低钾血症5例，腹膜炎3例；APACHEⅡ评分(17.74±4.82)分。两组患者性别、年龄、BMI、原发病及APACHEⅡ评分差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(王科 许毅 张艳)