护士主导肺康复管理方案在呼吸机依赖患者中的应用研究

doi:10.3761/j.issn.0254-1769.2023.15.002

摘要/Abstract

摘要：

目的构建护士主导肺康复管理方案，并探讨其对ICU呼吸机依赖患者的脱机时间、肺功能和活动功能的影响。方法组建多学科肺康复团队，构建护士主导肺康复管理方案，包括肺康复启动标准及脱机标准、呼吸目标训练、运动目标训练、目标镇痛镇静。采用便利抽样法，选取2021年6月—2022年10月ICU收治的呼吸机依赖患者30例为试验组，2019年6月—2021年5月收治的呼吸机依赖患者30例为对照组，试验组在常规护理的基础上接受护士主导肺康复管理方案，对照组给予常规气道护理和早期康复训练。比较两组呼吸机脱机成功率、脱机时间、ICU活动量表评分和氧合指数、6 min步行距离、ICU住院时间的差异。结果干预后，试验组的呼吸机脱机时间、ICU住院时间均短于对照组，ICU活动量表评分及6 min步行距离均优于对照组（P<0.05）；两组脱机成功率、氧合指数的比较，差异无统计学意义（P>0.05）。结论护士主导肺康复管理方案能有效缩短呼吸机依赖患者的脱机进程，改善患者的肺功能和活动功能，为临床护理实践提供指导。

关键词: 目标导向, 呼吸机依赖, 跨学科, 康复护理

Abstract:

Objective To establish a nurse-led pulmonary rehabilitation management program，and to explore its effects on the weaning time，lung function and activity function of ventilator-dependent patients in ICU. Methods By setting up a multidisciplinary pulmonary rehabilitation team and formulating the responsibilities of the nursing assistant，the nurse-led pulmonary rehabilitation management program was established，including the starting standard and weaning standard of pulmonary rehabilitation，respiratory target training，movement target training，target analgesia and sedation. By convenience sampling method，30 ventilators dependent patients admitted to ICU from June 2021 to October 2022 were selected as the experimental group，and 30 ventilators dependent patients admitted from June 2019 to May 2021 were selected as the control group. The experimental group received a nurse-led pulmonary rehabilitation management program on the basis of routine nursing. The control group was given routine airway care and early rehabilitation training. The differences of success rate，weaning time，ICU stay，oxygenation index，6-min walking distance and scores of ICU activity scale were compared between the 2 groups. Results The ICU stay time and weaning time of the experimental group were shorter than those of the control group；the scores of the ICU activity scale and the 6-min walking distance of the patients were better than those of the control group（P<0.05）. There was no significant difference in weaning success rate and oxygenation index between the 2 groups （P>0.05）. Conclusion The nurse-led pulmonary rehabilitation management program can effectively shorten the withdrawal process of ventilator-dependent patients，improve lung function and activity function，and provide guidance for clinical nursing practice.

Key words: Goal-Oriented, Ventilator-Dependent, Interdisciplinary, Rehabilitation Nursing

何彬, 杨郑, 莫蓓蓉, 何桂兰. 护士主导肺康复管理方案在呼吸机依赖患者中的应用研究[J]. 中华护理杂志, 2023, 58(15): 1802-1807.

HE Bin, YANG Zheng, MO Beirong, HE Guilan. Study on the construction of a nurse-led pulmonary rehabilitation management program and its application to ventilator-dependent patients in ICU[J]. Chinese Journal of Nursing, 2023, 58(15): 1802-1807.

图/表 2

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