Lee M Y, Kirk P M, Yarkony G M
Department of Rehabilitation Medicine, Northwestern University Medical School, Chicago, IL.
Arch Phys Med Rehabil. 1989 Jul;70(7):549-52.
Patients with viable phrenic nerves and adequate diaphragm and lung function can be freed from mechanical ventilation by the use of phrenic nerve pacers. Four quadriplegic patients with phrenic nerve pacers were admitted to a rehabilitation facility between April 1981 and September 1986. These patients made significant gains after undergoing a comprehensive rehabilitation program. They developed skills to maximize their independence, including independent electric wheelchair mobility and independent use of environmental control systems. They were able to communicate verbally by corking their tracheostomies, to write and type by using mouthsticks, and to use computers with mouth-sticks or pneumatic switches. All four patients were discharged to home with a family member as the primary care-provider. Successful discharge can be achieved only by adequate family teaching and counseling, optimal equipment prescription, adequate nursing and other community support for the primary care-provider, and close medical follow-up.
膈神经功能正常且膈肌和肺功能良好的患者可通过使用膈神经起搏器摆脱机械通气。1981年4月至1986年9月期间，四名佩戴膈神经起搏器的四肢瘫痪患者住进了一家康复机构。这些患者在接受全面康复计划后取得了显著进展。他们培养了各种技能以最大限度地实现自理，包括电动轮椅独立移动以及独立使用环境控制系统。他们能够通过封堵气管造口进行言语交流，使用口棒进行书写和打字，还能使用口棒或气动开关操作电脑。所有四名患者均在家庭成员作为主要护理者的情况下出院回家。只有通过充分的家庭指导和咨询、优化设备配置、为主要护理者提供足够的护理及其他社区支持以及密切的医学随访，才能实现成功出院。
