| 李磊,李静,喻鹏铭,何成奇.体外膈肌起搏对ICU获得性衰弱患者膈肌功能障碍有效性的研究分析[J].中国康复,2019,34(6):299-302 |
| 体外膈肌起搏对ICU获得性衰弱患者膈肌功能障碍有效性的研究分析 |
| Effects of external diaphragm pacer on diaphragmatic dysfunction in patients with intensive care unit-acquired weakness |
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| DOI： |
| 中文关键词: 体外膈肌起搏 ICU获得性衰弱 心肺康复 |
| 英文关键词: external diaphragm pacer intensive care unit acquired weakness cardiopulmonary rehabilitation |
| 基金项目:四川省卫健委资助项目（18PJ517） |
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| 中文摘要: |
| 目的：观察体外膈肌起搏对ICU获得性衰弱患者膈肌功能的疗效。方法:收集ICU获得性衰弱患者61例，随机分成对照组20例、观察组A 21例、观察组B 20例，分别给予常规治疗，常规治疗+早期心肺康复，常规治疗+早期心肺康复+体外膈肌起搏。在2周后进行膈肌活动度、膈肌厚度、最大吸气压（MIP）、Barthel指数、ICU住院时间测量，并记录。结果：治疗2周后，3组患者膈肌活动度、MIP均较治疗前明显提高（均P＜0.05）。膈肌活动度组间两两比较，结果示观察组B>观察组A>对照组（P＜0.05），对照组和观察组A无统计学差异（P=0.362），观察组B分别与对照组及观察组A差异有统计学意义（P＜0.01）。MIP：观察组B＞观察组A＞对照组(P＜0.01)；膈肌厚度及Barthel指数比较：观察组B＞观察组A＞对照组（P＜0.01）；ICU住院时间：观察组B＜观察组A＜对照组（P＜0.01）。 结论：体外膈肌起搏能够有效增加ICU获得性衰弱患者的膈肌肌力和耐力，改善患者通气功能，提高日常生活活动能力和生活质量，缩短ICU住院时间，具有较高的临床使用价值。 |
| 英文摘要: |
| Objective: To study the effect of the external diaphragm pacer (EDP) on intensive care unit acquired weakness ( ICU AW) with diaphragmatic muscle function. Methods: Sixty one patients with ICU AW in West China Hospital of Sichuan University were randomly divided into control group (n=20), treatment group A (n=21) and treatment group B (n=20). Three groups were given basic treatment, basic treatment + early cardiopulmonary rehabilitation, basic treatment + early cardiopulmonary rehabilitation + EDP, respectively. Diaphragm mobility, diaphragm thickness, maximal inspiratory pressure, Barthel index, and length of stay in ICU were measured and recorded after 2 weeks. Results: After the treatment for 2 weeks, the diaphragm mobility and MIP in the three groups were significantly increased as compared with those before treatment (P<0.05). The diaphragm mobility was compared within the group, and the results showed that group A> group B> control group. There was no statistically significant difference between the control group and the treatment group A (P=0.362). The difference between group B and control group or group A was statistically significant (P<0.01). Diaphragm thickness and Barthel index showed an order of group B > group A > control group. The length of stay in ICU was shortest in group B, followed by group A, and longest in control group. Conclusion: EDP can effectively increase the diaphragmatic muscle strength and endurance of ICU-AW patients, improve the ventilation function of patients, improve the ability of daily life activities and quality of life, and shorten the length of ICU hospitalization. |
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