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| Prevention effect of early rehabilitation based on multidisciplinary cooperation on ICU-acquired weakness in elderly AECOPD patients complicated with respiration failure |
| ZHANG Xia HOU Fang SU Li ZHANG Li▲ |
| Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830054, China |
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Abstract Objective To investigate the prevention effect of early rehabilitation based on multidisciplinary cooperation on ICU-acquired weakness (ICU-AW) in elderly acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients complicated with respiration failure. Methods From January 2017 to April 2019 , 80 cases with elderly AECOPD patients complicated with respiration failure in Department of Critical Care Medicine of the First Affiliated Hospital of Xinjiang Medical University were selected as observational objects. According to the random number table method, they were divided into the control group and the observation group, with 40 cases in each group. The control group was intervened with conventional mode of early rehabilitation, while the observation group was intervened with early rehabilitation based on multidisciplinary cooperation. Muscular strength was assessed by medical research council (MRC) score. Days on ventilator, ICU treatment, the hospitalization, incidences of ICU-AW, MRC score, activity of daily living (ADL) scores and occurrence of complications were compared in two groups. Results Days on ventilator, ICU treatment and the hospitalization of the observation group were lower than those of the control group, incidences of ICU-AW were lower than those of the control group, MRC score and ADL score after intervention of the observation group were higher than those of the control group and the incidence of complications were reduced, the differences were statistically significant (all P < 0.05). Conclusion Early rehabilitation based on multidisciplinary cooperation can effectively prevent incidence of ICU-AW in elderly AECOPD patients complicated with respiration failure. It can shorten time of mechanical ventilation, ICU treatment, improve activity of daily living and reduce incidence of complications, which is worthy of clinical application.
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[1] Jinjuvadia C，Jinjuvadia R，Mandapakala C，et al. Trends in Outcomes，Financial Burden，and Mortality for Acute Exacerbation of Chronic Obstructive Pulmonary Disease（COPD） in the United States from 2002 to 2010 [J]. COPD，2017，14（1）：72-79.
[2] 徐瑜，罗百灵.慢性阻塞性肺疾病急性加重期患者血清hs-CRP、CA-125和IL-6水平变化及临床意义[J].临床肺科杂志，2017，22（3）：458-460.
[3] 张爱梅，丁爱萍，陆烨华.早期活动预防慢性阻塞性肺疾病机械通气患者ICU获得性衰弱的效果[J].解放军护理杂志，2017，34（15）：44-46.
[4] 尤振香.早期综合干预预防机械通气患者重症监护病房（ICU）获得性衰弱发生的效果[J].中国卫生标准管理，2016，7（12）：209-210.
[5] 张莹，米元元.早期康复干预在预防ICU获得性衰弱中的研究进展[J].解放军护理杂志，2017，34（8）：48-51.
[6] 李亚玲，杨宝义，汪蓉.早期康复治疗对预防危重症患者ICU获得性衰弱的影响[J].中华现代护理杂志，2018，24（1）：56-59.
[7] 张珍祥.慢性阻塞性肺疾病急性加重期的定义及治疗[J].内科急危重症杂志，2009，15（5）：226-229.
[8] Balas MC，Vasilevskis EE，Burke WJ，et al. Critical care nurses′ role implementing the “ABCDE bundle” into practice [J]. Crit Care Nurse，2012，32（2）：35-38.
[9] 吴华炼，王勇，黄瑞瑜，等.系统化早期康复运动对ICU机械通气患者肌力及自理能力的干预效果[J].广东医学，2017，38（8）：1216-1219.
[10] 吴祎，钱风华，赵雷，等.喘可治注射液气道湿化对慢性阻塞性肺疾病急性加重期患者机械通气功能影响[J].上海中医药杂志，2017，51（4）：57-58，62.
[11] 李树铁，李媛莉，汪业铭，等.小剂量肝素在慢性阻塞性肺疾病急性加重期患者机械通气中的应用研究[J].实用临床医药杂志，2017，21（11）：189-190.
[12] 吴海珍，周洁.早期多元化护理干预对ICU获得性衰弱的影响[J].护理研究，2017，31（2）：251-253.
[13] 杨丽平，张志刚，张彩云，等.早期活动对ICU获得性衰弱干预效果的Meta分析[J].解放军护理杂志，2018，35（5）：1-7.
[14] 李苗苗，罗健，谢霖，等.预防ICU获得性谵妄和获得性衰弱的集束化策略研究进展[J].中华护理杂志，2018， 53（3）：358-362.
[15] 刘桃梅，周会兰.ICU患者早期活动的研究现状及进展[J].护理实践与研究，2017，14（22）：21-23.
[16] 刘晓博，史平，徐玲芬，等.ICU获得性衰弱干预策略的研究现状[J].护理与康复，2018，17（8）：38-42.
[17] 张倩倩，王冬梅，施月仙，等.康复锻炼在ICU获得性衰弱患者中应用的Meta分析[J].中华现代护理杂志，2017，23（21）：2780-2785.
[18] 田悦明，邹敏，张琪琪，等.ICU机械通气患者成功脱机拔管的影响因素分析[J].中国医药导报，2018，15（1）：60-63.
[19] Rehder KJ，Turner DA，Hartwig MG，et al. Active rehabilitation during extracorporeal membrane oxygenation as a bridge to lung transplantation [J]. Respir Care，2013， 58（8）：1291-1298.
[20] 俞萍，任国琴，陆小敏，等.早期活动与康复计划在ICU机械通气患者中的应用[J].护士进修杂志，2016，31（2）：161-164.
[21] 胡欢.ICU肿瘤重症患者应用营养支持疗法治疗的护理探究[J].中国医药科学，2019，9（4）：167-170.
[22] 章金蓉，费惠慧，何俊，等.改良森田疗法联合运动想象在老年职业性COPD患者肺康复中的运用[J].职业与健康，2018，34（23）：3206-3209. |
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