华西医学

华西医学

重症康复研究进展

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随着重症医学的不断发展,重症患者的存活率不断提高,但其残存的功能障碍问题对患者、患者家庭以及医疗保健系统造成的负担将产生持续深远的影响,并显著增加患者对后续康复治疗的需求。重症康复可在患者尚处在重症监护病房(intensive care unit,ICU)时就对其进行早期康复干预,并可防治并发症,预防功能退化和功能障碍,改善功能性活动能力和生活质量;同时缩短机械通气时间、ICU 住院时长和总住院时长,降低医疗支出。目前已有国内外专家共识认为重症患者的早期康复治疗是安全而有效的,故康复可以且应当尽早介入重症患者。但重症康复的推广目前仍受限于治疗安全参数的设定、ICU 文化、重症康复专业人员的匮乏以及患者的生理和精神认知状态等。目前国内外都在不断实践 ICU 中的康复治疗。

With the continuous development of critical care medicine, the survival rate of critical ill patients continues to increase. However, the residual dysfunction will have a far-reaching impact on the burden on patients, families, and health-care systems, and will significantly increase the demand of the follow-up rehabilitation treatment. Critical illness rehabilitation intervenes patients who are still in the intensive care unit (ICU). It can prevent complications, functional deterioration and dysfunction, improve functional activity and quality of life, shorten the time of mechanical ventilation, the length of ICU stay and hospital stay, and also reduce medical expenses. Experts at home and abroad believe that early rehabilitation of critical ill patients is safe and effective. So rehabilitation should be involved in critical ill patients as early as possible. However, the promotion of this model is still limited by the setting of safety parameters, the ICU culture, the lack of critical rehabilitation professionals, and the physiological and mental cognitive status of patients. Rehabilitation treatment in ICU is constantly being practiced at home and abroad.

关键词: 重症康复; 重症医学; 重症监护病房; 康复治疗; 综述文献

Key words: Critical illness rehabilitation; Critical care medicine; Intensive care unit; Rehabilitation therapy; Review

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