Lee Bonsan B, Boswell-Ruys Claire, Butler Jane E, Gandevia Simon C
Prince of Wales Spinal Medicine Department, Prince of Wales Hospital, Sydney, New South Wales, Australia.
J Spinal Cord Med. 2008;31(1):78-82. doi: 10.1080/10790268.2008.11753985.
Evaluation of noninvasive stimulation modalities to augment cough and assist tracheostomy decannulation in high-level tetraplegia.
Single case study.
A 65-year-old man with C4 ASIA C tetraplegia had delayed rehabilitation due to a tracheostomy and recurrent pneumonia primarily resulting from ineffective cough. Anterior surface electrical stimulation (SES) of the abdominal musculature was conducted to train an effective cough and enable decannulation. Training occurred daily for 4 weeks. The patient was tested 1 year later with posterolateral SES to determine the relative clinical effect of this delivery method.
At baseline, the addition of anterior SES increased maximal expiratory pressure (80%), maximal expiratory cough pressure (67%), and peak expiratory flow rate (11%). Three weeks after training began, the patient was decannulated following a program of SES and assisted and voluntary coughing. Upon testing 1 year later, SES with posterolaterally placed electrodes also produced an enhancement of voluntary cough attempts.
Noninvasive SES can potentially assist decannulation of tracheostomies.
评估非侵入性刺激方式对高位截瘫患者增强咳嗽及辅助气管切开拔管的作用。
单病例研究。
一名65岁的C4 ASIA C级截瘫男性患者，因气管切开及主要由无效咳嗽导致的反复肺炎而康复延迟。对腹部肌肉进行前表面电刺激（SES）以训练有效咳嗽并实现拔管。训练持续4周，每天进行。1年后对患者进行后外侧SES测试，以确定这种给药方式的相对临床效果。
基线时，增加前表面SES可使最大呼气压力提高80%，最大呼气咳嗽压力提高67%，呼气峰值流速提高11%。训练开始3周后，患者在接受SES以及辅助咳嗽和自主咳嗽方案后成功拔管。1年后测试时，后外侧放置电极的SES也增强了自主咳嗽尝试。
非侵入性SES可能有助于气管切开患者的拔管。
