持續性活動訓練對長期使用呼吸器病人之成效探討

Abstract

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。初步結果顯示，實驗組的呼吸器脫離率比控制組有較高趨勢(89.3% vs. 67.9%)，但沒有統計差異(p=0.051)。實驗組相較控制組，呼吸器使用日數較少(17.1±10.5 vs. 29.0±13.4，p=0.000)，亞急性呼吸照護病房日數也較少(21.5±9.6日 vs. 34.8±14.6日，p=0.000)，均具統計顯著差異；在總住院日數，實驗組與控制組分別為59.3±21.5日與70.5±24.4日，兩組沒有顯著差異(p=0.075)。長期使用呼吸器病人接受持續性活動訓練，可以降低呼吸器使用日數及亞急性呼吸照護病房入住日數。而呼吸器脫離成功率及總住院日數，沒有顯著成效。

Objective: This study investigates the effectiveness of an exercise program in facilitating ventilator weaning. The programs focused on mobility levels; however, the optimal duration of mobility training remains unclear. This study aims to evaluate the clinical effects of continuous mobility training in patients with prolonged mechanical ventilation. Methods: This randomized controlled trial enrolled participants from a respiratory care center, who were randomly assigned to two groups. The experimental group received both a standard ventilator weaning protocol and a continuous mobility training program, while the control group followed the standard ventilator weaning protocol combined with hand-cycle training. Outcomes measured included the ventilator weaning success rate, the duration of mechanical ventilation, length of stay in the respiratory care center and total hospital stay. Results: The success rate of ventilator weaning in the experimental group was higher than that in the control group (89.3% vs. 67.9%); however, there was no statistically significant difference (p=0.051). Compared with the control group, the length of mechanical ventilation (17.1±10.5 vs. 29.0±13.4, p=0.000) and the length of stay at the respiratory care center (21.5±9.6 vs. 34.8±14.6, p=0.000) were significantly shorter in the experimental group. The total lengths of hospital stay of the experimental and control groups were 59.3±21.5 and 70.5±24.4, respectively, without significant difference between the two groups (p=0.075). Conclusions: Continuous mobility training for patients with prolonged mechanical ventilation may reduce the length of mechanical ventilation and stay in the respiratory care center; however, it has no significant effect on the success rate of mechanical ventilation weaning and the total length of hospital stay.