文章摘要
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
  
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)
作者单位
李磊 四川大学华西医院康复医学中心四川省康复医学重点实验室成都 610041 
李静 四川省医学科学院·四川省人民医院康复医学科成都 610072 
喻鹏铭 四川大学华西医院康复医学中心四川省康复医学重点实验室成都 610041 
何成奇 四川大学华西医院康复医学中心四川省康复医学重点实验室成都 610041 
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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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