主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (4): 529-534.doi: 10.3969/j.issn.1672-1756.2025.04.009

• 论著 • 上一篇    下一篇

早期目标导向活动方案在机械通气患者中的应用

赵福华 袁萍 闫莉枞 王蓓   

  1. 宁夏医科大学总医院呼吸与危重症医学科,750004 银川市
  • 出版日期:2025-04-15 发布日期:2025-04-15
  • 通讯作者: 闫莉枞,硕士,主管护师,E-mail:2628258462@qq.com
  • 作者简介:赵福华,本科,主管护师
  • 基金资助:
    宁夏医科大学校级课题(XM2023011,XM2022055)

Application of Early Goal-Directed Mobilization protocol in mechanically ventilated patients

ZHAO Fuhua, YUAN Ping, YAN Licong, WANG Bei   

  1. Department of Respiratory and Critical Care Medicine, The General Hospital of Ningxia Medical University, Yinchuan, 750004, China
  • Online:2025-04-15 Published:2025-04-15
  • Contact: E-mail:2628258462@qq.com

摘要: 目的:分析早期目标导向活动方案在机械通气患者中的应用效果,为推进ICU患者早期活动的实施提供理论依据。方法:便利选取2024年1月—5月入住宁夏某三级甲等医院呼吸重症监护室的60例机械通气患者为研究对象,1月1日至3月15日收治的患者为对照组(n=30),3月16日至5月29日收治的患者为干预组(n=30)。对照组采取常规护理措施,干预组采取早期目标导向活动方案。比较两组患者机械通气时间、离床活动率、早期下床活动开始时间、ICU住院时间、ICU住院费用和不良事件发生率。结果:干预组患者的机械通气时间为(10.89±2.16)天,低于对照组的(13.13±2.70)天;离床活动率高于对照组(80.0%?vs?46.7%);早期下床活动开始时间早于对照组,(3.10±0.91)天vs(6.87±1.84)天;ICU住院时间低于对照组,(8.39±1.60)天vs(14.59±3.37)天;ICU住院费用低于对照组,(39?104.86±4?277.54)元vs(52?492.48±7?876.25)元;肺部感染发生率(3.3%?vs?26.7%)、压力性损伤发生率(3.3%?vs?30.0%)低于对照组,差异均具有统计学意义(P<0.05)。结论:早期目标导向活动方案可有效促进机械通气患者的康复,缩短机械通气时间和ICU住院时间,降低肺部感染发生率和压力性损伤发生率,减少ICU住院费用,促进早期下床活动和提高离床活动率,值得临床推广应用。

关键词: 机械通气;早期目标导向活动;多学科团队;重症监护

Abstract: Objective: To analyze the application effect of the Early Goal-Directed Mobilization protocol in mechanically ventilated patients and provide a theoretical basis for promoting early activity in the ICU. Methods: A convenience sample of 60 mechanically ventilated patients admitted to the respiratory ICU of a tertiary grade A hospital in Ningxia from January to May 2024 was selected for this study. Patients admitted from January 1 to March 15 were assigned to the observation group (n=30), and those admitted from March 16 to May 29 were assigned to the intervention group (n=30). The observation group received routine nursing care, while the intervention group received the Early Goal-Directed Mobilization protocol. Various outcomes were compared between the two groups, including mechanical ventilation time, rate of out-of-bed activities, time to initiate early out-of-bed activities, ICU length of stay, ICU costs, and incidence of adverse events. Results: The intervention group had significantly shorter mechanical ventilation time, (10.89±2.16) days vs (13.13±2.70) days, higher rate of out-of-bed activities (80.0% vs 46.7%), earlier time to initiate out-of-bed activities, (3.10±0.91) days vs (6.87±1.84) days, shorter ICU length of stay, (8.39±1.60) days vs (14.59±3.37) days, lower ICU costs, (39104.86±4277.54) yuan vs (52492.48±7876.25) yuan, and lower incidence of pulmonary infection (3.3% vs 26.7%) and pressure injury (3.3% vs 30.0%) compared to the observation group, with statistical significance (P<0.05). Conclusion: The Early Goal-Directed Mobilization protocol can effectively promote the recovery of mechanically ventilated patients, reduce mechanical ventilation time and ICU length of stay, decrease the incidence of pulmonary infection and pressure injury, significantly reduce ICU costs, and notably increase the time to initiate early out-of-bed activities and the rate of out-of-bed activities. It is worthy of clinical application and promotion.

Key words: mechanical ventilation; Early Goal-Directed Mobilization; Multidisciplinary Team; critical care

中图分类号:  R47;R197