目的 探讨在机械通气患者的治疗中采用体外膈肌起搏器联合早期康复训练的应用效果。方法 选取 2021 年 1 月—2023 年 4 月福建医科大学附属漳州市医院内科监护室收治的 119 例膈肌功能障碍机械通气患者，根据不同的康复训练方式分为对照组(n= 60，早期康复训练)与研究组(n= 59，体外膈肌起搏联合早期康复训练)。对比 2 组的血气指标、膈肌厚度及膈肌移动度、机械通气时间及住院时间、急性生理与慢性健康评分(acute physiology and chronic health score，APACHE Ⅱ)、肺部感染评分、并发症发生率。结果研究组动脉血二氧化碳分压(partial pressure of carbon dioxide in arterial blood，PaCO2)水平较低，血氧饱和度(oxygen saturation of blood，SaO2)、氧 合 指 数(partial pressure of oxygen/fraction of inspiration oxygen，PaO2/FiO2)水平高于对照组(P＜0。05)。研究组吸气末与呼气末膈肌厚度、膈肌移动度高于对照组(P＜0。05)。研究组APACHE Ⅱ、临床肺部感染评分(clinical pulmonary infection score，CPIS)低于对照组(P＜0。05)。研究组并发症发生率为 3。38%，低于对照组的 16。67%(P＜0。05);研究组机械通气时间(10。36±1。15)d及住院时间(19。16±1。53)d短于对照组[(13。58±1。43)d，(21。25±2。02)d](P＜0。05)。结论 在机械通气患者的治疗中采取体外膈肌起搏联合早期康复训练可改善其血气指标与膈肌功能，减少并发症的发生，促进患者病情好转，提高其健康水平。
The Effect of Extracorporeal Diaphragm Pacing Combined With Early Rehabilitation Training in Mechanically Ventilated Patients
Objective To investigate the effect of external diaphragm pacemaker combined with early rehabilitation training in the treatment of patients with mechanical ventilation.Methods A total of 119 patients with diaphragmatic dysfunction undergoing mechanical ventilation admitted to the Zhangzhou Affiliated Hospital of Fujian Medical University from January 2021 to April 2023 were selected and divided into two groups based on different rehabilitation training methods:the control group(n=60,early rehabilitation training)and the research group(n=59,external diaphragmatic pacing combined with early rehabilitation training).Blood gas index,diaphragm thickness and diaphragm movement,mechanical ventilation time and hospital stay,acute physiology and chronic health score(APACHEⅡ),and pulmonary infection score,complication rate were compared.Results The study group had lower levels of partial pressure of carbon dioxide in arterial blood(PaCO2),higher levels of oxygen saturation(SaO2),and higher levels of partial pressure of oxygen/fraction of aspiration oxygen(PaO2/FiO2)compared to the control group(P<0.05).The thickness of the diaphragm at the end of inhalation and expiration in the study group was higher than that in the control group(P<0.05).The APACHEⅡ and clinical pulmonary infection score(CPIS)of the study group were lower than those of the control group(P<0.05).The incidence of complications in the study group was 3.38%,lower than the control group's of 16.67%(P<0.05).The mechanical ventilation time(10.36±1.15)days and hospitalization time(19.16±1.53)days in the study group were shorter than those in the control group[(13.58±1.43)days,(21.25±2.02)days](P<0.05).Conclusion In the treatment of patients with mechanical ventilation,external diaphragm pacing combined with early rehabilitation training can improve the blood gas index and diaphragm function,reduce the occurrence of complications,promote the improvement of patients'condition and improve their health level,which is worthy of popularization and application.
mechanical ventilationexternal diaphragm pacingearly rehabilitation trainingdiaphragm functioncomplicationblood gas indicators
万方数据
维普
