危重病人的康复.docVIP

CHAPTER 60 第60章 ADITI G. SATTI , MELISSA DERR , AND MARY L. FORNEK ADITI G. SATTI , MELISSA DERR , AND MARY L. FORNEK Rehabilitation in the Intensive Care Unit CHAPTER OUTLINE Learning Objectives Introduction Case Study: Part 1 Rehabilitative Issues in the Icu Patient Case Study: Part 2 Whole Body Rehabilitation Inspiratory Muscle Training Early Tracheostomy to Facilitate Mobilization Case Study: Part 3 Psychological Dysfunction Speech Swallowing Dysfunction Case Study: Part 4 Sleep Implementing an Early Mobility Program Initial Assessmen Specialized Unit Approach to Early Mobility Rehabilitation Strategies Rehabilitation Programs Special Considerations Summary Review Questions Answers References Additional Readings 重症监护病人的康复 章节梗概 学习目标 前言 个案研究：第一部分 重症监护病人康复内容 个案研究：第二部分 整体康复 吸气力训练 保持气道通畅，早期气管造口？？？ 个案研究：第三部分 心理障碍 语言障碍 吞咽障碍 个案研究：第四部分 睡眠障碍 实施早期活动方案 初始评估t 专门早期活动病房？？？？ 康复策略 康复程序 特别考虑 摘要 复习问题 答案 参考文献 附加读物 LEARNING OBJECTIVES After studying this chapter, you should be able to: ■ Understand the importance of the team approach and the process of care issues, which lead to successful implemention of rehabilitation in the ICU patient. ■ Understand the main neuromuscular, respiratory, and psychological conditions that affect rehabilitation in the ICU. ■ Develop a systematic approach for implementing early mobility of ventilated patients. ■ Execute effective measures to prevent complications in ventilated patients in the ICU. 学习目标 通过本章节，你应该： 理解在重症监护病人康复实施成功中团队合作、护理内容和护理过程的重要性。 理解影响重症监护病人康复的主要因素：神经肌肉、呼吸及心理状态。 为机械通气患者制定实施早期活动的系统化的方法。 采取有效的措施预防重症监护室机械通气患者并发症。 INTRODUCTION 介绍 The goal of rehabilitation is to improve physical, psychological,and social function within the constraints of the patient’s illness. Muscle fatigue and weakness were the major reasons given for patient’s persistent functional limitation. 康复的主要目的是在病人病情允许的范围内提高患者的身体、心理及社会功能。呼吸机疲劳无力是病人功能持续受限的原因。下边左侧 The global advancement in ICU care has improved survival of the critically ill patient. This improved survival has