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    脓毒症康复期多维度综合干预模式的构建及预后评价

    Construction and prognostic evaluation of a multidimensional comprehensive intervention model for sepsis rehabilitation

    • 摘要: 目的 探讨脓毒症康复期多维度综合干预模式的构建方法并评价其临床应用效果。方法 采用随机对照研究,选取ICU转出的脓毒症患者110例,按照区组随机法分为干预组和对照组,每组55例。干预组实施含远程监测、抗生素降阶梯治疗、营养支持、运动康复、心理社会干预及中医传统疗法的多维度综合干预,对照组接受常规诊疗,以30 d再住院率为主要结局。结果 干预组血氧饱和度、尿量、肌力(MRC评分)显著高于对照组,心率、降钙素原水平显著低于对照组(均P<0.05);干预组并发症发生率、30 d再住院率显著低于对照组,SF-36生活质量评分和Barthel指数评分显著优于对照组(均P<0.05)。结论 脓毒症康复期多维度综合干预模式可有效改善患者的生理功能,降低并发症发生率与再住院风险,提升生活质量和自理能力,具有良好的临床应用与推广价值。

       

      Abstract: Objective To explore the construction of a multidimensional comprehensive intervention model for sepsis during the rehabilitation period and evaluate its clinical application.Methods This is a randomized controlled study. A total of 110 sepsis patients who were transferred from the ICU were selected and divided into two groups (n=55) using block randomization: an intervention group and a control group. Patients in the intervention group received multidimensional comprehensive intervention, including remote monitoring, step-down antibiotic therapy, nutritional support, exercise rehabilitation, psychosocial intervention, and traditional Chinese medicine therapy. Those in the control group underwent routine treatment. Primary outcome was the 30-day readmission rate.Results The intervention group showed significantly higher blood oxygen saturation, urine output, and muscle strength (MRC score) than the control group (all P<0.05). Heart rate and procalcitonin levels were significantly lower in the intervention group (all P<0.05). Compared with the control group, the intervention group showed significant reduction in the incidence of complications and 30-day readmission rate and increases in SF-36 quality of life scores and Barthel index scores (all P<0.05).Conclusions The multidimensional comprehensive intervention model during the rehabilitation period of sepsis can effectively improve patients' physiological functions, reduce complications and readmission risks, enhance quality of life and self-care ability, with good clinical application and promotion value.

       

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