干扰电疗法对重症监护下意识障碍患者肌肉萎缩的预防作用研究

Study on the preventive effect of interference electric therapy on muscular atrophy in patients with subconscious disorder in intensive care

目的探索干扰电疗法对重症监护下意识障碍患者肌肉萎缩的预防作用。方法选取2017年1月—2020年6月揭阳市人民医院收治的40例意识障碍患者作为研究对象,按照随机数字表法分为试验组(20例)与对照组(20例)。对照组患者采用被动运动方法治疗,试验组患者在对照组基础上增加1次/d干扰电治疗。通过CT观察比较两组患者股前肌室(AT)、股后肌室(PT)、腿前肌室(AL)和腿后肌室(PL)的横截面积变化,以入院时的肌肉横截面积为100%计算肌肉横截面积百分比的变化,表征干扰电疗法对患者肌肉萎缩的预防作用。当患者下肢活动能力或者意识水平改善后,停止干扰电疗法。结果6例试验组患者在干扰电疗法治疗过程中意识水平改善,患者AT、PT、AL和PL面积百分比高于对照组,差异有统计学意义(P<0.05);14例试验组患者接受干扰电治疗后,大腿肌肉横截面积百分比在治疗第14、21、28、35和42天时高于对照组,差异有统计学意义(P<0.05)。结论干扰电疗法可以有效地预防重症监护下意识障碍患者的肌肉萎缩,有助于维持患者的肌肉功能,为患者苏醒后的康复治疗打下了良好基础。

Objective To explore the preventive effect of interference electrical therapy on muscle atrophy in patients with subconscious disorder in intensive care.Methods A total of 40 patients with disorders of consciousness admitted to Jieyang People's Hospital from January 2017 to June 2020 were selected as the research subjects and divided into the experimental group(20 cases)and the control group(20 cases)according to the random number table method.Patients in the control group were treated by passive movement method only,and patients in the experimental group were treated by adding 1 time/d interferential electrotherapy on top of the control group.The changes in the cross-sectional areas of the anterior femoral compartment(AT),posterior femoral compartment(PT),anterior leg compartment(AL)and posterior leg compartment(PL)of the two groups were compared by CT observation,and the changes in the ratio of muscle cross-sectional area were calculated using the muscle cross-sectional area at the time of admission as 100%to characterize the preventive effect of interferential electrotherapy on muscle atrophy in patients.Interferential electrical therapy was discontinued when the patient's lower extremity mobility or level of consciousness improved.Results The level of consciousness improved in 6 patients in the experimental group during the treatment with interferential electrotherapy,and the percentages of AT,PT,AL and PL area were higher in the patients than those in the control group,and the differences were statistically significant(P<0.05);the percentage of thigh muscle cross-sectional area in 14 patients in the experimental group after receiving interferential electrotherapy was higher than that in the control group at days 14,21,28,35 and 42 of treatment,and the difference was statistically significant(P<0.05).Conclusion Interference electrical therapy can effectively prevent muscle atrophy in patients with subconscious disorder in intensive care,help maintain the patient's muscle function,and lay a good foundation for rehabilitation after the patient wakes up.