Study On Application Of Early Rehabilitative Intervention In General-ICU

Objects:With the development of medical technology,particularly the survival period of the hospitalized patients prolonged.Patients with severe disease is now turning into an important part among the hospitalized patients.The current comprehensive trea- tments can palpablely reduce the death rate.However,the corresponding sequelae grow day by day.So,the Early Rehabilitative Intervention,to recover the limb functions and enhance the quality of life,have been proved to be the current research hotspots.The aim of this paper is to discuss carrying out Early Rehabilitative Intervention based on the conventional therapy to the Critical patients in General ICU, clarify the application value of early rehabilitation therapy on patients in ICU. Methods:86 critically ill patients in general-ICU of our hospital from July 2014 to July 2015 were chosen and divided randomly into rehabilitation group and conventional group,each group of 43 patients.The patients were taken the lying good limb position,turned back once every 2 hours with backslapping.According to the needs of patients,anti-infective therapy,mechanical ventilation,nutritional support,regulation of water, acid-base balance etc.The rehabilitation group also received early rehabilitation intervention from a professional rehabilitation team, including: position and body posture;cinesiatrics;respiratory movement;physical agents therapy;raditional Chinese medicine therapy;mind-cure;Deglutition training;speech therapy;Daily Living Activity training.Assess comprehensively the patient conditions,draw up individualized rehabilitation program,execute early rehabilitation measures. According to the patients' different conscious state,tolerance conditions,and disease development,revise timely the rehabilitation programs.If the patient is in a confusional state,or has poor cognitive function,The bedside passive limb function training could be given;If the patient is lucid,and the myodynamia is below level 3,the limb function training is mainly from passive activities;if the myodynamia is above level 2,then the limb function training is mainly from active exercise;throughout the whole process,daily life ability training should be carried out;if the sedative is nec- essary,try to apply at night if possible,suspend the sedative for 1-2hours before rehabilitation.That helps patients to complete the mandatory action better; Early Rehabilitative treatment time starts from 10 min,gradually increase to 30 min,for twice per day,continued for more than 28 days.After leaving ICU,the rehabilitation treatments should be continued by the same group of rehabilitation physicians, therapysts.Compare constitutional index,incidence of post-treatment adverse of the two groups, before and after treatment APACHE II score and BI,28-day mortality,ICU stay,mechanical ventilation duration.Analyze statistically using SPSS17.0 software. Results:From the analyze statistically, pre-treatment constitutional index,incidence of treatment adverse events,28-day mortality of the two groups was no significant difference(P>0.05).Patients of rehabilitation group had less ICU stay and shorter mechanical ventilation duration,there was statistical difference(P<0.05). For patients of both groups,28 days after treatment,the BI rose significantly than on admission;compareing to the conventional group,the BI rose much more significantly for the rehabilitation group;and there was statistical difference(P<0.05). For all the patients, the APACHE? score significantly reduced,and there was statistical difference(P<0.05).But the post-treatment APACHE? score of the two groups showed no significant statistical difference(P>0.05). Conclusion:The Early Rehabilitative Intervention conducted by a professional rehabilitation team to the general-ICU patients can significantly reduce the mechanical ventilation duration and ICU stay,without increasing 28-day mortality or incidence of adverse events.Early Rehabilitative Intervention can improve much better the critically ill patient's basic life ability.Early Rehabilitative Intervention conducted by a professional rehabilitation team to the general-ICU patients is safe,reliable and effective.