SICU重症患者身体功能和活动能力调查分析
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摘要
目的调查分析外科ICU(SICU)患者身体功能现状及活动能力水平,为开展早期活动以促进患者快速康复提供参考。方法采用方便抽样法选取SICU符合条件患者100例,应用切尔西危重患者身体功能评估工具(CPAx)和佩尔梅危重患者活动评分量表进行评估。结果 SICU患者身体功能评分3～29(14.83±1.91)分,活动能力评分3～15(8.30±1.62)分;是否使用血管活性药物及机械通气的患者身体功能评分比较,差异有统计学意义(均P<0.01);不同年龄段、是否使用身体约束及机械通气、有无引流管的患者活动能力评分比较,差异有统计学意义(P<0.05,P<0.01)。结论 SICU患者的身体功能和活动能力评分较低,需积极开展重症患者群体中早期活动相关评估,实施适宜的干预措施,改善重症患者的预后和生存质量。
Objective To investigate surgical ICU patients′ physical function status and activity level, to provide basis for early mobi-lity programs, and to facilitate rapid recovery of patients.Methods A total of 100 eligible surgical ICU patients were sampled by convenient sampling method and the activity level of patients was assessed by the Chelsea Critical Care Physical Assessment Tool(CPAx) and the Perme Intensive Care Unit Mobility Score.Results The physical function score ranging from 3 to 29 points with a mean of 14.83 and a standard deviation of 1.91, was significantly different in patients on vasoactive drugs and mechanical ventilation therapy or not(P<0.01 for both); the activity level scores ranging from 3 to 15 points with a mean of 8.30 and a standard deviation of 1.62, was significantly different in patients with varied ages, whether or not to use physical restraint, mechanical ventilation and whether or not to have drainage tubes(P<0.05,P<0.01).Conclusion Surgical ICU patients have lower scores of physical function and activity level. Early activity-related assessment should be conducted among critically ill patients and approp-riate interventions should be implemented to improve the prognosis and quality of life of these patients.
Objective To investigate surgical ICU patients′ physical function status and activity level, to provide basis for early mobi-lity programs, and to facilitate rapid recovery of patients.Methods A total of 100 eligible surgical ICU patients were sampled by convenient sampling method and the activity level of patients was assessed by the Chelsea Critical Care Physical Assessment Tool(CPAx) and the Perme Intensive Care Unit Mobility Score.Results The physical function score ranging from 3 to 29 points with a mean of 14.83 and a standard deviation of 1.91, was significantly different in patients on vasoactive drugs and mechanical ventilation therapy or not(P<0.01 for both); the activity level scores ranging from 3 to 15 points with a mean of 8.30 and a standard deviation of 1.62, was significantly different in patients with varied ages, whether or not to use physical restraint, mechanical ventilation and whether or not to have drainage tubes(P<0.05,P<0.01).Conclusion Surgical ICU patients have lower scores of physical function and activity level. Early activity-related assessment should be conducted among critically ill patients and approp-riate interventions should be implemented to improve the prognosis and quality of life of these patients.
引文
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[16] 杨富,方芳,陈兰,等.ICU早期康复的研究进展[J].护理学杂志,2017,32(10):100-103.
[2] 胡细玲,陈妙霞,凌聪,等.早期渐进性活动训练促进重症监护病房机械通气患者神经肌肉功能恢复的效果观察[J].现代临床护理,2012,11(10):17-19.
[3] 何玲英,黄丽华.危重患者活动评估工具的研究进展[J].护理与康复,2017,16(4):329-332.
[4] Corner E J, Wood H, Englebretsen C, et al.The Chelsea Critical Care Physical Assessment Tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study[J].Physiotherapy,2013,99(1):33-41.
[5] Perme C, Nawa R K, Winkelman C, et al.A tool to assess mobility status in critically ill patients: the Perme Intensive Care Unit Mobility Score[J].Methodist Debakey Cardiovasc J,2014,10(1):41-49.
[6] 何玲英,黄丽华,张月丽.佩尔梅危重患者活动评分量表的汉化及信效度检测[J].护理与康复,2017,16(11):1144-1148.
[7] Nawa R K, Lettvin C, Winkelman C, et al.Initial interrater reliability for a novel measure of patient mobility in a cardiovascular intensive care unit[J].J Crit Care,2014,29(3):471-475.
[8] Herridge M S, Tansey C M, Matté A, et al.Functional disability 5 years after acute respiratory distress syndrome[J].N Engl J Med,2011,364(14):1293-1304.
[9] Latronico N, Rasulo F A.Presentation and management of ICU myopathy and neuropathy[J].Curr Opin Crit Care,2010,16(2):123-127.
[10] 岳萌,姚培宇,崔楚云,等.机械通气患者早期活动效果的系统评价[J].中华护理杂志,2016,51(5):551-557.
[11] Kandeel N A, Attia A K.Physical restraints practice in adult intensive care units in Egypt[J].Nurs Health Sci,2013,15(1):79-85.
[12] 沈小玲,沈雅芬.患者病情严重程度评估工具在临床护理工作中的应用[J].中华护理杂志,2011,46(6):601-602.
[13] 王涛,王烁,唐子人,等.影响急诊危重症病人预后的危险因素分析[J].首都医科大学学报,2017,38(4):597-603.
[14] 张英杰,元小冬,赵营,等.无创脑水肿动态监测对神经危重症患者病情及预后的评估[J].临床神经病学杂志,2016,29(5):355-358.
[15] 张晶,田丽.危重症患者疼痛评估量表的研究现状[J].国际麻醉学与复苏杂志,2014,35(8):752-756,760.
[16] 杨富,方芳,陈兰,等.ICU早期康复的研究进展[J].护理学杂志,2017,32(10):100-103.