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针刺治疗对改善重症监护病房长期机械通气患者呼吸状况的疗效:一项回顾性观察研究。

Efficacy of Acupuncture Treatment for Improving the Respiratory Status in Patients Receiving Prolonged Mechanical Ventilation in Intensive Care Units: A Retrospective Observational Study.

作者信息

Matsumoto-Miyazaki Jun, Ushikoshi Hiroaki, Suzuki Kodai, Miyazaki Nagisa, Nawa Takahide, Okada Hideshi, Yoshida Shozo, Murata Ichijiro, Ogura Shinji, Minatoguchi Shinya

机构信息

1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan .

2 Advanced Critical Care Center, Gifu University Hospital , Gifu, Japan .

出版信息

J Altern Complement Med. 2018 Nov;24(11):1076-1084. doi: 10.1089/acm.2017.0365. Epub 2018 May 9.

Abstract

BACKGROUND AND OBJECTIVE

Patients in critical care settings often require prolonged mechanical ventilation (MV) therapy and, occasionally, they cannot be weaned from MV. The authors evaluated the efficacy of acupuncture treatment for improving the respiratory status and promoting successful weaning from prolonged MV in patients at intensive care units (ICUs).

DESIGN

Retrospective observational study.

SETTING

Gifu University Hospital, Gifu, Japan.

SUBJECTS

The authors included 16 tracheostomized patients receiving MV for >21 days at the ICU of Gifu University Hospital, who underwent acupuncture therapy for improving their respiratory status.

INTERVENTION

Acupuncture treatment was conducted in four sessions per week.

OUTCOME MEASURES

The data of tidal volume (VT), respiratory rate (RR), heart rate (HR), oxygen saturation as measured by pulse oximetry (SpO), dynamic lung compliance (Cdyn), rapid shallow breath index (RSBI; RR/VT) values before and immediately after acupuncture were extracted from the medical records.

RESULTS

The median number of days on MV before acupuncture initiation was 31 days. VT and Cdyn were significantly increased immediately after acupuncture (all p < 0.001), whereas RR, HR, and RSBI were significantly decreased (all p < 0.05). Eleven patients were successfully weaned from MV after acupuncture initiation. In the weaning success group, VT and Cdyn were significantly increased (all p < 0.01), whereas RR, HR, and RSBI were significantly decreased (all p < 0.05) after acupuncture. Conversely, in the weaning failure group, these values were not changed significantly. The increase in Cdyn after acupuncture was larger in the weaning success group than in the weaning failure group (p < 0.05).

CONCLUSION

Acupuncture treatment might have beneficial effects on the respiratory status of ICU patients receiving MV and may help in weaning from prolonged MV. Further large prospective cohort studies are warranted.

摘要

背景与目的

重症监护病房的患者常需要长时间机械通气(MV)治疗,有时无法撤机。作者评估了针刺治疗对改善重症监护病房(ICU)患者呼吸状况及促进其从长时间MV成功撤机的疗效。

设计

回顾性观察研究。

地点

日本岐阜市岐阜大学医院。

研究对象

作者纳入了16例在岐阜大学医院ICU接受MV超过21天且接受针刺治疗以改善呼吸状况的气管切开患者。

干预措施

每周进行4次针刺治疗。

观察指标

从病历中提取针刺前后的潮气量(VT)、呼吸频率(RR)、心率(HR)、脉搏血氧饱和度(SpO)、动态肺顺应性(Cdyn)、快速浅呼吸指数(RSBI;RR/VT)数据。

结果

针刺开始前MV的中位天数为31天。针刺后VT和Cdyn立即显著增加(均p < 0.001),而RR、HR和RSBI显著降低(均p < 0.05)。11例患者在针刺开始后成功撤机。在撤机成功组,针刺后VT和Cdyn显著增加(均p < 0.01),而RR、HR和RSBI显著降低(均p < 0.05)。相反,在撤机失败组,这些值无显著变化。撤机成功组针刺后Cdyn的增加大于撤机失败组(p < 0.05)。

结论

针刺治疗可能对接受MV的ICU患者的呼吸状况有益,并可能有助于从长时间MV撤机。有必要进行进一步的大型前瞻性队列研究。

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