Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-V...Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke.However,these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke.This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University.The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training.The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training.There were no obvious side effects.These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.展开更多
目的观察规范化分级早期康复方案在重症监护病房(ICU)机械通气患者中的应用效果,为患者康复方案的制定提供参考。方法选择2021年7月至2022年6月温州医科大学附属第一医院ICU收治的30例机械通气患者作为对照组(接受常规康复方案);选择同...目的观察规范化分级早期康复方案在重症监护病房(ICU)机械通气患者中的应用效果,为患者康复方案的制定提供参考。方法选择2021年7月至2022年6月温州医科大学附属第一医院ICU收治的30例机械通气患者作为对照组(接受常规康复方案);选择同期本院ICU收治的87例机械通气患者作为试验组(按上机后24~48、>48~72、>72~96 h 3个时间点,每个时间点29例,实施规范化分级康复方案)。观察两组机械通气时间、ICU住院时间、总住院时间,以及转入ICU 24 h、转出ICU时急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、ICU获得性肌无力(ICU-AW)、呼吸机相关性肺炎(VAP)和谵妄发生率、撤机成功率、不良事件发生率的变化。结果试验组随时间延长,机械通气时间、ICU住院时间、总住院时间均逐渐延长,ICU-AW、VAP、谵妄发生率和不良事件发生率均逐渐升高,撤机成功率逐渐降低;转入ICU 24 h APACHEⅡ评分无明显变化,转出ICU时逐渐升高;但试验组上机后24~48、>48~72、>72~96 h各时间点机械通气时间、ICU住院时间、总住院时间均较对照组明显缩短〔机械通气时间(d):6.45±1.78、7.64±2.03、9.17±2.09比12.66±2.14,ICU住院时间(d):10.78±3.48、12.56±4.33、15.23±3.29比19.53±5.22,总住院时间(d):20.58±5.36、26.44±6.23、28.50±5.79比37.45±9.08,均P<0.05〕,ICU-AW、VAP、谵妄发生率和不良事件发生率以及APACHEⅡ评分均较对照组明显降低〔ICU-AW发生率:3.45%(1/29)、13.79%(4/29)、20.69%(6/29)比33.33%(10/29),VAP发生率:0%(0/29)、10.34%(3/29)、13.79%(4/29)比26.67%(8/29),谵妄发生率:0%(0/29)、13.79%(4/29)、13.79%(4/29)比46.67%(14/30),不良事件发生率:3.45%(1/29)、13.79%(4/29)、24.14%(7/29)比36.67%(11/29),APACHEⅡ评分(分):6.28±2.62、8.78±2.95、10.67±3.08比14.56±3.53,均P<0.05〕,撤机成功率较对照组明显升高〔100.00%(29/29)、93.10%(27/29)、86.21%(25/29)比76.67%(23/30),均P<0.05〕。结论规范化分级早期康复方案能有效缩短ICU患者机械通气、住院时间,降低患者ICU-AW、VAP、谵妄风险,促进患者快速康复,临床应用疗效确切。展开更多
基金supported by the Medical Scientific Research Project of Chongqing Municipal Health Commission of China,Nos.2018ZDXM022,2019MSXM017 and 2020MSXM106a grant from Chongqing General Hospital of China,No.2019ZDXM03(all to LCN and JXM).
文摘Transcutaneous auricular vagus nerve stimulation(ta-VNS)is a novel noninvasive treat-ment for stroke that directly stimulates the peripheral auricular branch of the vagus nerve.There have been recent reports that ta-VNS combined with conventional rehabilitation training promotes the recovery of neurological function of patients with acute stroke.However,these were small-sample-sized studies on the recovery of neurological function in patients after percutaneous vagus nerve stimulation in the subacute and chronic phases after stroke.This double-blinded randomized controlled trial involved 60 acute ischemic or hemorrhagic stroke patients aged 18-80 years who received treatment in the Second Affiliated Hospital of Chongqing Medical University.The subjects were randomly assigned to receive ta-VNS or sham ta-VNS combined with conventional rehabilitation training.The follow-up results over 1 year revealed that ta-VNS combined with conventional rehabilitation training greatly improved the recovery of motor and sensory functions and emotional responses compared with sham ta-VNS combined with conventional rehabilitation training.There were no obvious side effects.These findings suggest that ta-VNS combined with conventional rehabilitation training for the treatment of acute ischemic or hemorrhagic stroke patients is safe and effective.
文摘目的观察规范化分级早期康复方案在重症监护病房(ICU)机械通气患者中的应用效果,为患者康复方案的制定提供参考。方法选择2021年7月至2022年6月温州医科大学附属第一医院ICU收治的30例机械通气患者作为对照组(接受常规康复方案);选择同期本院ICU收治的87例机械通气患者作为试验组(按上机后24~48、>48~72、>72~96 h 3个时间点,每个时间点29例,实施规范化分级康复方案)。观察两组机械通气时间、ICU住院时间、总住院时间,以及转入ICU 24 h、转出ICU时急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、ICU获得性肌无力(ICU-AW)、呼吸机相关性肺炎(VAP)和谵妄发生率、撤机成功率、不良事件发生率的变化。结果试验组随时间延长,机械通气时间、ICU住院时间、总住院时间均逐渐延长,ICU-AW、VAP、谵妄发生率和不良事件发生率均逐渐升高,撤机成功率逐渐降低;转入ICU 24 h APACHEⅡ评分无明显变化,转出ICU时逐渐升高;但试验组上机后24~48、>48~72、>72~96 h各时间点机械通气时间、ICU住院时间、总住院时间均较对照组明显缩短〔机械通气时间(d):6.45±1.78、7.64±2.03、9.17±2.09比12.66±2.14,ICU住院时间(d):10.78±3.48、12.56±4.33、15.23±3.29比19.53±5.22,总住院时间(d):20.58±5.36、26.44±6.23、28.50±5.79比37.45±9.08,均P<0.05〕,ICU-AW、VAP、谵妄发生率和不良事件发生率以及APACHEⅡ评分均较对照组明显降低〔ICU-AW发生率:3.45%(1/29)、13.79%(4/29)、20.69%(6/29)比33.33%(10/29),VAP发生率:0%(0/29)、10.34%(3/29)、13.79%(4/29)比26.67%(8/29),谵妄发生率:0%(0/29)、13.79%(4/29)、13.79%(4/29)比46.67%(14/30),不良事件发生率:3.45%(1/29)、13.79%(4/29)、24.14%(7/29)比36.67%(11/29),APACHEⅡ评分(分):6.28±2.62、8.78±2.95、10.67±3.08比14.56±3.53,均P<0.05〕,撤机成功率较对照组明显升高〔100.00%(29/29)、93.10%(27/29)、86.21%(25/29)比76.67%(23/30),均P<0.05〕。结论规范化分级早期康复方案能有效缩短ICU患者机械通气、住院时间,降低患者ICU-AW、VAP、谵妄风险,促进患者快速康复,临床应用疗效确切。
