康复干预对ICU脑卒中患者安全性的相关研究(1)
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【摘要】 目的 研究重症监护室(ICU)重症脑卒中患者在病情相对稳定后行早期康复治疗并观察其安全性。方法 康复组患者病情相对稳定后且在严密监护情况下，行心理辅导，早期吞咽功能训练及简单发音训练，胸肺物理治疗，头、颈部躯干及四肢的早期主、被动康复运动治疗及感应电治疗。对照组则以常规内科药物治疗。结果 康复组患者院内感染率、压疮发病率及下肢静脉血栓形成均明显低于对照组，在统计学上差异有统计学意义(P<0.05)。而室性心律失常、急性左心衰竭、脑疝的发病率，康复组与对照组相比，差异无统计学意义(P>0.05)。结论 ICU的重症脑卒中患者，在病情相对稳定后针对病情特点，制定相应康复治疗方案，予早期康复干预治疗应为可行、安全的。
【关键词】
重症脑卒中；重症监护室；康复治疗；安全性
The related research of the safety on ICU patients with rehabilitation interventions
CHEN Dong-qing,ZHENG Min, TANG Shun-luan,et al.
Department of Physiotherapy,Shantou Central Hospital 515031,China
【Abstract】 Objective To study the effect and safety andof early rehabilitation interventions on ICU patients with severe stroke under relatively stable conditionMethods The ICU patients in rehabilitation group performedthe psychological counseling, training and early swallowing simple pronunciation training, chest physical therapy, head, neck, trunk and limbs of the early active and passive rehabilitation exercise therapy and induction electrical treatment after relatively stable condition and close guardianship. The ICU patients in control group performed routine medical drug treatment. Results The nosocomial infection rate, the incidence of pressure ulcers and lower extremity venous thrombosiswere significantly lower in rehabilitation group than that inthe control group with statistically significant difference (P<0.05).And there were no statistical difference (P>0.05)of the incidence of ventricular arrhythmia, acute left ventricular failure, brain herniation between the rehabilitation group and the control group. Conclusion The early rehabilitation interventions have feasible effect and safety in the ICU patients with severe stroke under the relatively stable condition
【Key words】
Severe stroke; Intensive care unit; Rehabilitation treatment;Safety
收住ICU的重症脑卒中患者，不但病情危重，且常合并心血管疾病、糖尿病、肾功能不全和慢性阻塞性肺病等多种基础性疾病，康复治疗的强度掌握不当易诱发各基础性疾病病情恶化，加大了康复治疗风险性，致使早期康复治疗是否得益存争议。本研究主要观察收住ICU重症脑卒中患者在病情相对稳定后行早期康复治疗的安全性。
1 资料与方法
1.1 一般资料 114例患者均为 2008年1月至2010年9月在我院ICU住院并确诊为急性重症脑卒中患者，符合我国现行脑血管病的诊断标准。114例患者随机分为康复组和对照组，康复组和对照组均予常规内科药物治疗，脑出血患者必要时予钻颅引流减压治疗，出现呼吸衰竭者予呼吸机机械辅助通气 ......
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