摘要目的：评价机械通气患者在早期功能锻炼中运用和顺精准医疗模式的效果。方法使用随机数字表将2013年3月至2016年3月ICU收治的152例机械通气患者分为对照组和干预组各76例，对照组遵循研究前ICU常规流程进行患者管理，干预组给予常规治疗及护理的同时，运用和顺精准医疗模式为患者实施早期功能锻炼。比较2组患者的机械通气时间、ICU住院日、谵妄、呼吸机相关性肺炎、压疮、深静脉血栓和肺不张等并发症的发生率、脱机成功率和功能锻炼依从性。结果干预组患者机械通气时间和ICU住院日分别为（5.01±1.03）、（8.04±1.11）d，对照组为（8.01±1.01）、（10.14±0.96）d，2组比较差异有统计学意义（t=-17.48、-12.48，均P<0.01）；干预组谵妄、呼吸机相关性肺炎和深静脉血栓的发生率分别为9.21%（7/76）、3.95%（3/76）和1.32%（1/76），对照组为21.05%（16/76）、14.47%（11/76）和10.53%（8/76），2组比较差异有统计学意义（χ2=4.15、5.04、5.79，均P<0.05）；干预组功能锻炼的依从性和脱机成功率分别为100%(76/76)和95%(72/76)，对照组为70%（53/76）和80%（61/76）。2组比较差异有统计学意义（χ2=27.10、7.28，均P<0.05）。结论和顺精准医疗模式下，医、护、治疗师联合实施机械通气患者早期功能锻炼，具有良好的临床效果，能够降低并发症的发生率，保证患者安全，促进患者康复。

abstractsObjective To evaluate the effect of the application of Heshun precise medical model in early functional exercise of mechanically ventilated patients. Methods Totally 152 ICU patients were divided into the control group and the intervention group with 76 patients in each group using a random number table from March 2013 to March 2016, the control group followed the pre study ICU routine process for patient management. While the intervention group received routine treatment and nursing care, Heshun precise medical model was used for patients to do early functional exercise. The following items were compared between two groups of patients, such as mechanical ventilation time and ICU stay, the incidence of delirium, ventilator associated pneumonia (VAP), bedsore and deep venous thrombosis (DVT) and pulmonary atelectasis complications, weaning success rate and functional exercise compliance. Results The duration of mechanical ventilation of patients and the ICU days of hospitalization of the intervention group were (5.01 ± 1.03) and (8.04 ± 1.11) days, and the control group were (8.01 ± 1.01) and (10.14 ± 0.96) days, whose difference were statistically significant (t=-17.48,-12.48, P < 0.01). The incidence of delirium, VAP and DVT of the intervention group were 9.21% (7/76), 3.95% (3/76) and 1.32% (1/76), and the control group were 21.05% (16/76), 14.47% (11/76) and 10.53% (8/76), whose difference were statistically significant (χ2=4.15, 5.04, 5.79, P<0.05). The functional exercise compliance and weaning success rate of the intervention group were 100%(76/76) and 95%(72/76), and the control <br> group were 70% (53/76) and 80% (61/76). The difference were statistically significant (χ2=27.10, 7.28, P <0.05). Conclusions Under the Heshun precise medical model, doctors, nurses, therapists implement mechanical ventilation in patients with early functional exercise jointly has a good clinical effect, which can reduce the incidence of complications, ensure the patient′s safety and promote recovery.