早期康复治疗对重型颅脑外伤患者呼吸机相关性肺炎的预防效果研究
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摘要
目的探讨早期康复治疗对重型颅脑外伤患者呼吸机相关性肺炎的预防效果。方法选取我院2016年6月至2018年12月收治的重型颅脑外伤患者50例,随机分为常规治疗组和早期康复组,比较两组患者的呼吸机相关性肺炎(VAP)发生率和相关指标。结果早期康复组的VAP发生率、机械通气时间、 ICU住院时间均显著低于常规治疗组(P <0.05),两组的30 d病死率无显著差异(P>0.05)。治疗1周后,早期康复组的GCS评分显著高于常规治疗组(P <0.05),感染指标PCT、 CRP显著低于常规治疗组(P <0.05)。结论早期康复治疗可以有效预防重型颅脑外伤患者呼吸机相关性肺炎的发生。
Objective To investigate the preventive effect of early rehabilitation therapy on ventilator-associated pneumonia in patients with severe craniocerebral trauma. Methods A total of 50 patients with severe craniocerebral trauma admitted to our hospital from June 2016 to December 2018 were selected and randomly divided into the conventional therapy group and early rehabilitation group. The incidence of ventilator-associated pneumonia(VAP) and related indicators were compared between the two groups. Results The incidence of VAP, mechanical ventilation time and ICU hospitalization time of early rehabilitation group were significantly lower than those of conventional therapy group(P <0.05); No significant difference was found in the 30-day mortality rate between the two groups(P >0.05). 1 week after treatment, the GCS score of early rehabilitation group was significantly higher than that of conventional therapy group, and the infection indicators including PCT and CRP were significantly lower than those of conventional therapy group(P <0.05). Conclusions Early rehabilitation therapy can effectively prevent the incidence of ventilator-associated pneumonia in patients with severe craniocerebral trauma.
Objective To investigate the preventive effect of early rehabilitation therapy on ventilator-associated pneumonia in patients with severe craniocerebral trauma. Methods A total of 50 patients with severe craniocerebral trauma admitted to our hospital from June 2016 to December 2018 were selected and randomly divided into the conventional therapy group and early rehabilitation group. The incidence of ventilator-associated pneumonia(VAP) and related indicators were compared between the two groups. Results The incidence of VAP, mechanical ventilation time and ICU hospitalization time of early rehabilitation group were significantly lower than those of conventional therapy group(P <0.05); No significant difference was found in the 30-day mortality rate between the two groups(P >0.05). 1 week after treatment, the GCS score of early rehabilitation group was significantly higher than that of conventional therapy group, and the infection indicators including PCT and CRP were significantly lower than those of conventional therapy group(P <0.05). Conclusions Early rehabilitation therapy can effectively prevent the incidence of ventilator-associated pneumonia in patients with severe craniocerebral trauma.
引文
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[2]Waters B,Muscedere J.A 2015 update on ventilator-associated pneumonia:new insights on its prevention,diagnosis,and treatment[J].Curr Infect Dis Rep,2015,17(8):41.
[3]Jovanovic B,Milan Z,Markovic-Denic L,et al.Risk factors for ventilator-associated pneumonia in patients with severe traumatic brain injury in a Serbian trauma centre[J].Int J Infect Dis,2015,38:46-51.
[4]Engels PT,Beckett AN,Rubenfeld GD,et al.Physical rehabilitation of the critically ill trauma patient in the ICU[J].Crit Care Med,2013,41(7):1790-1801.
[5]Mendez-Tellez PA,Needham DM.Early physical rehabilitation in the ICU and ventilator liberation[J].Respir Care,2012,57(10):1663-1669.
[6]Yosef-Brauner O,Adi N,Ben Shahar T,et al.Effect of physical therapy on muscle strength,respiratory muscles and functional parameters in patients with intensive care unit-acquired weakness[J].Clin Respir J,2015,9(1):1-6.
[7]Morris PE,Goad A,Thompson C,et al.Early intensive care unit mobility therapy in the treatment of acute respiratory failure[J].Crit Care Med,2008,36(8):2238-2243.