運用加護病房活動量表協助長期呼吸器病人復健運動訓練之成效

長期使用呼吸器的病人常常因呼吸肌肉無力，使脫離呼吸器更加困難，單位人員對於肢體復健的方式缺乏一致性作法，因此激發團隊找尋不同介入等措施來提升肌肉力量。文獻回顧時，採用系統性文獻分析及實證文獻評析方法，以PICO方式找尋出3篇文獻之可用方案，並於確立方案後，運用於臨床並評估其成效。本次研究亞急性呼吸照護病房共20位呼吸器病人參與，並以加護病房活動量表（IMS），評估病人活動能力及設定給予漸進式之復健運訓練。訓練期間採用跨團隊合作方式，由復健師、護理師與呼吸治療師及家屬共同參與。執行期間為一年（2021年5月1日至2022年4月30日）共20位使用呼吸器病人，進行復健運動訓練，頻率為一週五次，一天2次，一次30分鐘。結果有18位病人成功脫離呼吸器，平均運動時間16.3天，11位病人加護病房活動功能量表等級由1進步到3－4，呼吸器使用天數平均為21.3天。本研究經漸進式復健運動介入，對呼吸器使用病人之身體活動功能是有幫助。

關鍵字

呼吸器；肢體運動；早期運動；漸進式運動

並列摘要

Patients with prolonged mechanical ventilation often had difficulty weaning due to weak respiratory muscles. A systematic literature analysis and critical appraisal of literature were used. Use the PICO method to find out the available methods of the three literatures and apply them in clinic. There were twenty patients with mechanical ventilator in the sub-acute respiratory care unit. Progressive rehabilitation program was provided according to ICU mobility scale (IMS) of the patient. Interprofessional collaborative practice model was adopted, with the participation of physical therapists, nurses, respiratory therapists and family and relatives. The clinical application period was from May 1, 2021 to May 31, 2022. Average days of rehabilitation were 16.3 days and mechanical ventilator weaning days were 21.3 days. 11 patients improved from level 1 to level 3-4 in IMS and 18 patients successfully weaned from mechanical ventilators. The progressive rehabilitation program improved physical activity function in patients with mechanical ventilator.

並列關鍵字

mechanical ventilation ； early mobilization ； intensive care unit ； progressive rehabilitation program

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