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电阻抗成像技术在重症呼吸康复中的应用

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电阻抗成像(EIT)技术由于能够在床旁进行无创、实时、动态、无辐射的肺通气检测,被广泛应用于重症呼吸管理.本研究从EIT技术基本原理(物理原理、数学原理和医学原理)、临床常用的EIT监测功能、EIT在重症呼吸系统疾病康复中的应用以及存在的不足和展望等方面进行阐述,以期为EIT技术的临床康复应用提供参考.其中,临床常用的EIT监测功能主要包括EIT肺通气功能监测(与空间相关的参数和与时间相关的参数)、EIT灌注分布监测;EIT在重症呼吸系统疾病康复中的应用主要包括康复早期活动安全性评估,指导呼吸康复方案制订和动态评估呼吸康复疗效(精确指导肺复张、气道廓清治疗、呼吸肌训练、个性化通气设置和评价呼吸康复干预效果);EIT在重症呼吸系统疾病康复应用的不足主要包括图像稳定性不足与信号重建影响监测效果、个性化调整EIT设置尚未形成共识、有效性和安全性有待进一步验证、参数解读与检查报告缺乏标准和规范;未来还需要进一步优化EIT技术,推进数据融合,并建立EIT使用的国际标准和指导原则,以实现基于EIT的个体化、精细化重症康复全流程管理.
Application of Electrical Impedance Tomography Technology in Critical Respiratory Rehabilitation
Electrical impedance tomography(EIT)is a technology widely used in respiratory management of critical patients that enables noninvasive,real-time,dynamic and radiation-free lung ventilation monitoring at the bedside.This study encompasses the fundamental physical,mathematical and medical principles of EIT,alongside its commonly utilized clinical monitoring function-alities,applications in the rehabilitation of critical respiratory diseases,and the shortcomings and prospects of EIT,in order to pro-vide references for the application of EIT in clinical rehabilitation.The key clinical monitoring functionalities of EIT predominantly entail lung ventilation monitoring,encompassing both spatial and temporal parameters,as well as perfusion distribution monitoring.In the context of critical respiratory disease rehabilitation,EIT finds applications in early rehabilitation activity safety assessment,guiding the formulation of respiratory rehabilitation plans,and dynamically assessing rehabilitation effectiveness.This includes pro-viding precise guidance for lung recruitment,airway clearance therapy,respiratory muscle training,individualized ventilation set-tings,and evaluating the effects of respiratory rehabilitation interventions.Limitations in the application of EIT for critical respiratory diseases rehabilitation primarily include insufficient image stability and signal reconstruction affecting monitoring effectiveness,alongside the lack of consensus on personalized adjustment of EIT settings,the necessity for further validation of effectiveness and safety,and the absence of standards and norms in parameter interpretation and examination reporting.Future efforts should prioritize optimizing EIT technology,advancing data fusion techniques and establishing international standards and guidelines for its utiliza-tion to achieve personalized and refined management throughout the entire critical care rehabilitation process based on EIT.

critical rehabilitationelectrical impedance tomographyrespiratory supportpulmonary ventilationrespiratory managementairway clearance

潘化平

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南京医科大学附属江宁医院,江苏 南京 211100

泰康之家康复医院(燕园总院),北京 102200

重症康复 电阻抗成像 呼吸支持 肺通气功能 呼吸管理 气道廓清

2024

康复学报
福建中医药大学

康复学报

CSTPCD
影响因子:0.545
ISSN:2096-0328
年,卷(期):2024.34(6)