体外膈肌起搏器对脑卒中机械通气患者的疗效观察

Effect of external diaphragm pacemaker on patients with mechanical ventilation after stroke

目的 探讨体外膈肌起搏器对脑卒中机械通气患者的疗效.方法 选择自2014年1月至2017年7月入住南部战区总医院神经外科重症监护室(NICU)的100例脑卒中机械通气患者,根据患者家属意愿将其分为治疗组(n=50)和对照组(n=50).对照组患者给予常规治疗,治疗组患者在常规治疗基础上增加体外膈肌起搏器治疗,治疗30 d后比较2组患者的撤机率、肺部感染发生率及2组撤机患者的机械通气时间、入住NICU的时间和膈肌移动度.结果 治疗30 d后,与对照组比较,治疗组患者的撤机率增加,肺部感染的发生率降低,差异有统计学意义(P<0.05);与对照组中撤机患者比较,治疗组中撤机患者入住NICU的时间、机械通气时间降低,膈肌移动度增加,差异有统计学意义(P<0.05).结论 体外膈肌起搏器可以通过改善膈肌功能来提高撤机率,并且减少机械通气时间和肺部感染的发生.

Objective To explore the effect of external diaphragm pacemaker (EDP) in patients with mechanical ventilation after stroke. Methods One hundred patients with mechanical ventilation after stroke, admitted to our hospital from January 2014 and July 201, were assigned to a control group and an observation group (n=50) according to the willing of the patient family. All the patients received routine ICU treatment; patients from the observation group were additionally given external diaphragm pacemaker (EDP). After 30 d of treatment, the incidence of respiratory infections and percentage of total subjects of weaned, diaphragmatic excursion, duration in ICU, and duration of mechanical ventilation were compared between the two groups. Results As compared with those in the control group, the percentage of subjects of weaned and diaphragmatic excursion were significantly increased, and the duration in ICU, duration of mechanical ventilation, and incidence of respiratory infections were significantly decreased in the observation group (P<0.05). Conclusion EDP treatment may increase the percentage of subjects of weaned by improving the diaphragmatic function, which can decrease the duration of mechanical ventilation and incidence of respiratory infections in patients with mechanical ventilation after stroke.