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使用神经肌肉电刺激来维持重症患者腹部和胸部肌肉厚度:一项随机临床试验。

Use of neuromuscular electrical stimulation to preserve the thickness of abdominal and chest muscles of critically ill patients: A randomized clinical trial.

作者信息

Dall' Acqua Ana M, Sachetti Amanda, Santos Laura J, Lemos Fernando A, Bianchi Tanara, Naue Wagner S, Dias Alexandre S, Sbruzzi Graciele, Vieira Silvia R R

出版信息

J Rehabil Med. 2017 Jan 19;49(1):40-48. doi: 10.2340/16501977-2168.

Abstract

OBJECTIVE

To evaluate and compare the effects of neuromuscular electrical stimulation combined with conventional physical therapy on muscle thickness in critically ill patients.

DESIGN

Double-blind, randomized controlled trial.

PATIENTS

Twenty-five patients participated in the study.

METHODS

Patients on mechanical ventilation for 24-48 h were randomized to an intervention group (neuromuscular electrical stimulation + conventional physical therapy) or a conventional group (sham neuromuscular electrical stimulation + conventional physical therapy). Primary outcome was thickness of the rectus abdominis and chest muscles, determined on cross-sectional ultrasound images before and after the intervention.

RESULTS

Eleven patients were included in the intervention group and 14 in the conventional group. After neuromuscular electrical stimulation, rectus abdominis muscle thickness and chest muscle thickness were preserved in the intervention group, whereas there was a significant reduction in thickness in the conventional group, with a significant difference between groups. There was a significant difference between groups in length of stay in the intensive care unit, with shorter length of stay in the intervention group.

CONCLUSION

There was no change in rectus abdominis and chest muscle thickness in the intervention group. A significant decrease was found in these measures in the conventional group.

摘要

目的

评估并比较神经肌肉电刺激联合传统物理治疗对重症患者肌肉厚度的影响。

设计

双盲随机对照试验。

患者

25名患者参与了该研究。

方法

接受机械通气24 - 48小时的患者被随机分为干预组(神经肌肉电刺激 + 传统物理治疗)或传统组(假神经肌肉电刺激 + 传统物理治疗)。主要结局指标是干预前后通过横断面超声图像测定的腹直肌和胸部肌肉厚度。

结果

干预组纳入11名患者,传统组纳入14名患者。神经肌肉电刺激后,干预组腹直肌厚度和胸部肌肉厚度得以保留,而传统组厚度显著降低,两组间存在显著差异。重症监护病房住院时间两组间存在显著差异,干预组住院时间较短。

结论

干预组腹直肌和胸部肌肉厚度无变化。传统组这些指标显著下降。

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