| 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. |
