Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang.
Department of Rehabilitation, Beijing Rehabilitation Hospital of Capital Medical University, Beijing.
Int J Rehabil Res. 2022 Sep 1;45(3):195-200. doi: 10.1097/MRR.0000000000000535. Epub 2022 Jun 23.
To investigate the effect of pulmonary rehabilitation combined with diaphragm pacemaker therapy on the diaphragm function of severely ill patients on mechanical ventilation. Forty patients were randomly divided into the control group (CG; n = 20) and experimental group (EG; n = 20). The CG was given basic ICU nursing and conventional rehabilitation treatment. The EG added a diaphragm pacemaker and pulmonary rehabilitation therapies along with basic ICU nursing and conventional rehabilitation treatment. The relevant indexes were compared at baseline and postintervention, including the Glasgow Coma Scale (GCS), Acute Physiology, Chronic Health Evaluation II (APACHE II) scores, diaphragm mobility and thickness. The indexes of mechanical ventilation time, ICU and total hospital stays were compared between the two groups. There was no difference in the GCS and APACHE II scores, and diaphragm mobility and thickness between the two groups before treatment (P > 0.05). After 30 days of treatment, the GCS scores increased in both groups, the APACHE II scores decreased significantly, and diaphragm mobility and thickness decreased compared with before treatment (P < 0.05), but the improvement of each index in the EG was more evident than in the CG. Compared with the CG, the indexes of the EG, including offline, ICU and total hospitalization times, were significantly shorter (P < 0.05). Additionally, there were no adverse events such as accidental tube detachment or falling out of bed during treatment. Pulmonary rehabilitation combined with a diaphragm pacemaker is safe and effective in treating severely ill mechanically ventilated patients.
探讨肺康复联合膈肌起搏器治疗对机械通气危重症患者膈肌功能的影响。
将 40 例患者随机分为对照组(CG;n=20)和实验组(EG;n=20)。CG 给予基础 ICU 护理和常规康复治疗。EG 在基础 ICU 护理和常规康复治疗的基础上增加膈肌起搏器和肺康复治疗。比较两组患者在基线和干预后的格拉斯哥昏迷量表(GCS)、急性生理学和慢性健康评估 II (APACHE II)评分、膈肌移动度和厚度等相关指标。比较两组患者机械通气时间、入住 ICU 时间和总住院时间。
两组患者治疗前 GCS 评分和 APACHE II 评分、膈肌移动度和厚度比较差异均无统计学意义(P>0.05)。治疗 30 天后,两组患者 GCS 评分均升高,APACHE II 评分明显下降,膈肌移动度和厚度较治疗前降低(P<0.05),但 EG 组各指标改善程度均优于 CG 组。与 CG 组相比,EG 组患者脱机时间、入住 ICU 时间和总住院时间明显缩短(P<0.05)。此外,治疗过程中均未发生意外脱管或坠床等不良事件。
肺康复联合膈肌起搏器治疗机械通气危重症患者安全有效。