| 刘晶涛,董大伟,陆巍,陈俊杉.神经肌肉电刺激对ICU患者肌力及临床结局影响的系统评价[J].中国康复,2019,34(11):599-604 |
| 神经肌肉电刺激对ICU患者肌力及临床结局影响的系统评价 |
| Influences of Neuromuscular Electrical Stimulation on Muscle Strength and Clinical Outcomes in ICU Patients: A Systematic Review |
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| DOI： |
| 中文关键词: 神经肌肉电刺激 ICU获得性衰弱 重症监护室 危重症患者 系统评价 |
| 英文关键词: neuromuscular electrical stimulation ICU-AW intensive care units critical illness systematic review |
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| 中文摘要: |
| 目的:系统评价神经肌肉电刺激对ICU患者肌力及临床结局的干预效果。方法:计算机检索Cochrane Library、Web of Science、PubMed、中国知网、维普以及万方数据库中从建库至2018年12月公开发表的关于神经肌肉电刺激在ICU患者中应用效果的随机对照试验，由两名研究人员独立对文献筛选、数据提取和文献质量进行评价。采用Revman5.3软件对符合质量标准的文献中的结局指标进行Meta分析。结果:共纳入14篇文献。6篇文献报告了患者的MRC总评分，Meta分析结果显示：观察组MRC总评分高于对照组［MD=4.14，95%CI（2.69，5.58），P＜0.01］；6篇文献报道了患者住ICU期间的机械通气时间，Meta分析结果显示：观察组机械通气时间较对照组明显缩短［MD=-2.19，95%(-4.09,-0.30),P=0.02］；5篇文献报道了患者的住ICU时间，Meta分析结果显示: 观察组住ICU时间较对照组明显缩短［MD=-1.80，95%CI（-3.33，-0.27），P=0.02］。结论:神经肌肉电刺激在ICU患者中应用是安全有效的，可提高MRC评分，缩短机械通气时间和住ICU时间，但仍需要多中心、大样本随机对照试验进一步证明。 |
| 英文摘要: |
| Objective: To systematically review the effects of neuromuscular electrical stimulation (NMES) on muscle strength and clinical outcomes in ICU patients. Methods: Six databases including Cochrane Library, Web of Science, PubMed, CNKI, VIP and Wanfang database were searched for related literature from database established to December 2018. Randomized controlled trials (RCT) about the effects of NMES in ICU patients were collected. Literature screening, data extraction and quality evaluation were independently performed by two researchers. Meta-analysis was performed using RevMan software (version 5.3). Results: Fourteen studies were eventually included. The total MRC score of the patients was reported in 6 literature, and the Meta analysis results showed that the total MRC score in the observation group was significantly higher than that in the control group ［MD=4.14, 95% CI (2.69, 5.58), P < 0.01］. Six literature reported the mechanical ventilation time of patients in ICU, and Meta analysis results showed that the mechanical ventilation time in the observation group was significantly shorter than in the control group ［MD=-2.19, 95% CI (-4.09, -0.30), P=0.02］. The length of ICU stay in the observation group was significantly shorter than that in the control group ［MD=-1.80, 95% CI (-3.33, -0.27), P=0.02］. Conclusion: The application of NMES in ICU patients is safe and effective. NMES can enhance MRC score, and shorten mechanical ventilation time and ICU stay. Also, Large sample and multi-center RCTs are needed to confirm the effects of NMES. |
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