| 祖丽皮努尔·阿卜杜萨迪克,王宝兰.体外膈肌起搏联合肺康复对慢阻肺急性加重期患者膈肌和外周骨骼肌功能的影响[J].中国康复,2023,38(5):291-295 |
| 体外膈肌起搏联合肺康复对慢阻肺急性加重期患者膈肌和外周骨骼肌功能的影响 |
| The effect of external diaphragm pacer combined with pulmonary rehabilitation on the function of diaphragm and peripheral skeletal muscle in patients with acute exacerbation of COPD |
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| DOI： |
| 中文关键词: 体外膈肌起搏 慢性阻塞性肺疾病急性加重期 膈肌 外周骨骼肌 |
| 英文关键词: external diaphragm pacer acute exacerbation of chronic obstructive pulmonary disease diaphragm function peripheral skeletal muscle function |
| 基金项目:新疆维吾尔自治区自然科学基金（2020D01C262） |
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| 摘要点击次数: 1880 |
| 全文下载次数: 1913 |
| 中文摘要: |
| 目的：观察体外膈肌起搏(EDP)联合肺康复对慢性阻塞性肺疾病急性加重期（AECOPD）机械通气患者骨骼肌功能的影响，以及膈肌功能变化与外周骨骼肌功能、活动能力的相关关系。方法：选取70例行有创机械通气治疗的AECOPD患者，按随机数字表法分为观察组和对照组各35例，2组均给予常规临床干预，对照组给予常规肺康复治疗，观察组在常规肺康复治疗基础上给予EDP治疗，2组患者治疗时间为2周。比较2组患者治疗前后的膈肌活动度(DE)、膈肌增厚分数(DTF)、肱二头肌厚度（BRT）、股四头肌厚度（QMT）、医学研究理事会量表（MRC-score）、莫顿活动指数（DEMMI），机械通气（MV）和ICU入住时间。结果：治疗2周后，与本组治疗前比较，2组患者DE、DTF、BRT、QMT、MRC、DEMMI均提高(P<0.05)。与对照组比较，观察组患者治疗后DE、DTF、BRT、QMT、MRC、DEMMI 均升高（P<0.05），MV和ICU入住天数均降低(P<0.05)。DE、DTF的提高与BRT、QMT、DEMMI的提高成正相关（P<0.01）。结论：体外膈肌起搏联合肺康复能够通过改善AECOPD机械通气患者的膈肌功能和外周骨骼肌功能，间接改善患者呼吸功能和活动能力，缩短机械通气和ICU入住时间，且膈肌运动和收缩力的提高可明显改善肱二头肌和股四头肌厚度和DEMMI。 |
| 英文摘要: |
| Objective: To observe the effect of external diaphragm pacer (EDP) combined with pulmonary rehabilitation on the diaphragm and peripheral skeletal muscle function in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients undergoing mechanical ventilation (MV), and the correlation between changes in diaphragm function and peripheral skeletal muscle function and mobility. Methods: A total of 70 patients with AECOPD who needed invasive MV were selected, and randomly divided into the control group and the experimental group (n=35 each) by a random number table. Both groups were given routine clinical intervention. The experimental group was given EDP therapy on the basis of conventional pulmonary rehabilitation therapy, and the control group was given conventional pulmonary rehabilitation therapy. The differences in indexes before and after the treatment were compared between two groups, including diaphragm excursion (DE), diaphragm thickening fraction (DTF), Biceps brachii thickness (BRT), quadriceps muscle thickness (QMT), medical research council score (MRC), de Morton mobility index (DEMMI), duration of MV and ICU stay. Results: After 2 weeks of the treatment, as compared with those before the treatment, DE, DTF, BRT, QMT, MRC and DEMMI in two groups were increased, with statistical significance (P<0.05). As compared with the control group, DE, DTF, BRT, QMT, MRC and DEMMI in the experimental group were increased after the treatment with the differences being statistically significant (P<0.05). The duration of MV and ICU stay were shorter in the experimental group than those in the control group with the differences being statistically significant (P<0.05). The improvement of DE and DTF was positively correlated with the improvement of BRT, QMT and DEMMI (P<0.01). Conclusion: EDP combined with pulmonary rehabilitation can improve diaphragm function and peripheral skeletal muscle function of AECOPD patients undergoing MV, indirectly improve respiratory function and mobility, and shorten days of MV and ICU stay. The increases of movement and contraction of diaphragm significantly improved thickness of biceps brachii and quadriceps muscle and de Morton mobility index. |
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