体外膈肌起搏对AECOPD机械通气患者的有效性研究

Efficacy of external diaphragmatic pacing in patients with AECOPD mechanical ventilation

目的探讨体外膈肌起搏对慢性阻塞性肺疾病急性加重期(AECOPD)机械通气患者的肺康复效果的影响。方法将80例患有AECOPD且需要有创机械通气的患者随机分为试验组和对照组各40例,试验组在常规肺康复治疗基础上给予体外膈肌起搏治疗,对照组给予常规肺康复治疗,比较两组患者治疗后的膈肌活动度、膈肌增厚分数、机械通气时间、ICU入住天数和撤机成功率。结果试验组膈肌活动度、膈肌增厚分数和撤机成功率均高于对照组(P<0.05),而机械通气时间和ICU入住天数均低于对照组(P<0.05)。结论体外膈肌起搏联合肺康复更有利于改善AECOPD机械通气患者的膈肌功能,缩短机械通气时间和ICU入住天数,比常规肺康复治疗具有更大优势,在AECOPD机械通气患者的康复治疗中具有参考性价值。

Objective To investigate the effect of external diaphragm pacing on the rehabilitation of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)undergoing mechanical ventilation.Methods 80 patients with AECOPD who needed invasive mechanical ventilation were randomly divided into the experimental group(n=40)and the control group(n=40).The experimental group was given external diaphragm pacing(EDP)therapy on the basis of conventional pulmonary rehabilitation therapy,and the control group was given conventional pulmonary rehabilitation therapy.After treatment,diaphragm activity,diaphragm thickening fraction,mechanical ventilation time,length of ICU stay and success rate of withdrawal were compared between the two groups.Results Diaphragm activity,diaphragm thickening score and success rate of deactivation in experimental group were higher than those in control group(P<0.05),while mechanical ventilation time and ICU stay time were significantly shorter than those in control group(P<0.05).Conclusion EDP combined with pulmonary rehabilitation is more beneficial to improve the diaphragm function of patients with AECOPD mechanical ventilation,shorten the duration of mechanical ventilation and ICU stay,and has greater advantages than conventional pulmonary rehabilitation,which has reference value in the rehabilitation of patients with AECOPD mechanical ventilation.