持續性復健活動訓練對慢性呼吸衰竭使用呼吸器病人的成效

Effect of Continuous Mobility Training Rehabilitation in Chronic Respiratory Failure Patients with Mechanical Ventilation

林啟文(Chi-Wen Lin) ； 趙遠宏(Yuan-Hung Chao) ； 劉建明(Chien-Ming Liu) ； 何瓊文(Chiung-Wen Ho)

《台灣醫學》 27卷3期 (2023/05) Pp. 269-278

https://doi.org/10.6320/FJM.202305_27(3).0003

摘要

復健運動介入可協助長期使用呼吸器病人，提昇身體動作功能及改善呼吸器脫離，但復健運動介入內容多元。本研究目的為針對慢性呼吸衰竭使用呼吸器病人，設計持續性復健活動訓練，進行前瞻性隨機分配控制研究，針對由加護病房轉入亞急性呼吸照護病房的病人，控制組執行常規呼吸器脫離計畫，及手踏車訓練，實驗組執行常規呼吸器脫離計畫及持續性復健活動訓練，並就呼吸器脫離成功率、亞急性呼吸照護病房呼吸器使用日數、亞急性呼吸照護病房住院日數、總住院天數進行分析。實驗組的呼吸器脫離率比控制組有較高趨勢（86.4% vs. 63.6%），但沒有統計差異（p =0.082）。實驗組相較控制組，呼吸器使用日數較少（19.2±10.8 vs. 29.4±13.1，p=0.008），亞急性呼吸照護病房日數也較少（22.7±10.2日 vs. 32.8±13.1日，p=0.007），均具統計顯著差異；兩組的總住院日數沒有統計差異（p=0.696）。

關鍵字

呼吸器 ； 呼吸器脫離 ； 復健

並列摘要

Rehabilitation exercise intervention can help participants with prolonged mechanical ventilation improve physical function and ventilator weaning; however, the content of rehabilitation exercise intervention is diverse and inconsistent. This study aims to design the content of continuous rehabilitation mobility training and examine the clinical effects in chronic respiratory failure patients with mechanical ventilation. This prospective, single-center, concealed allocation, evaluator-blind, randomized control study divided participants transferred from the intensive care unit to the subacute respiratory care ward into two groups. The control group underwent the routine ventilator weaning plan and hand bicycle training, while the experimental group underwent routine ventilator weaning plan and continuous rehabilitation mobility training. The success rate of ventilator weaning, the length of mechanical ventilation, the length of stay at the respiratory care center, and total length of hospital stay were analyzed. The success rate of ventilator weaning in the experimental group was higher than that in the control group (86.4% vs. 63.6%); however, there was no statistically significant difference (p=0.082). Compared with the control group, the length of mechanical ventilation (19.2±10.8 vs. 29.4±13.1, p=0.008) and the length of stay at the respiratory care center (22.7±10.2 vs. 32.8±13.1, p=0.007) was lesser in the experimental group, with statistically significant differences. The total lengths of hospital stay of the experimental and control groups were 62.6±22.8 and 65.1±20.8, respectively, without significant difference between the two groups (p=0.696).

並列關鍵字

mechanical ventilator ； ventilator weaning ； rehabilitation