【摘要】 目的：探讨早期肺康复联合ESCAPE集束化护理对ICU有创机械通气患者呼吸机相关膈肌功能障碍(VIDD)的影响。方法：将2023年2月1日～12月31日综合ICU收治的41例成人有创机械通气患者随机分为实验组20例和对照组21例，其中实验组3例、对照组4例因转出ICU而脱落，最终纳入实验组和对照组各17例。实验组给予早期肺康复训练联合ESCAPE集束化护理，对照组给予ESCAPE集束化护理。比较两组膈肌移动度及增厚率、临床肺部感染评分(CPIS)、急性生理学与慢性健康状况评分(APACHEⅡ)。结果：实验组治疗后膈肌移动度高于治疗前(P<0.05),膈肌增厚率比较差异无统计学意义(P>0.05);实验组治疗后CPIS、APACHEⅡ评分均低于治疗前(P<0.05)。结论：早期肺康复联合ESCAPE集束化护理可改善ICU有创机械通气患者的膈肌移动度，降低肺部感染发生风险、改善健康状况，减轻膈肌萎缩，控制ICU呼吸机相关性肺炎。更多还原

【Abstract】 Objective: To investigate the effect of early pulmonary rehabilitation combined with escape bundle care on ventilator-induced diaphragmatic dysfunction in intensive care units(ICU)patients undergoing invasive mechanical ventilation.Methods: From February 1 to December 31,2023,41 adults invasively ventilated patients admitted to the Comprehensive ICU were randomly divided into the experimental group of 20 cases and the control group of 21 cases.Among them, 3 cases in the experimental group and 4 cases in the control group fell out of the ICU due to transfer.Finally, 17 cases were included in the experimental group and 17 cases in the control group.The experimental group received early lung rehabilitation training combined with ESCAPE bundled care management, while the control group received ESCAPE bundled care management.The diaphragmatic mobility and thickening, clinical pulmonary infection score(CPIS),acute physiology and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score were compared between two groups.Results: After treatment, the movement of the diaphragm in the experimental group was higher than before treatment(P<0.05),and there was no statistically significant difference in the thickening rate of the diaphragm(P>0.05).The APACHE Ⅱ and CPIS scores after treatment in the experimental group were lower than those before treatment(P<0.05).Conclusion: Early pulmonary rehabilitation combined with ESCAPE bundle care management can improve diaphragmatic mobility in ICU patients with invasive mechanical ventilation, reduce the risk of pulmonary infection, improve health status, alleviate diaphragmatic atrophy, and control ICU ventilator-associated pneumonia.更多还原