神经肌肉电刺激在慢性阻塞性肺疾病急性加重早期肺康复的应用  

Neuromuscular electrical stimulation of pulmonary rehabilitation in early AECOPD patient

作　　者：李晓聪[1] 徐远达[1] 

机构地区：[1]广州医科大学附属第一医院重症医学科,510120

出　　处：《国际呼吸杂志》2014年第17期1338-1342,共5页International Journal of Respiration

摘　　要：COPD是我国常见的呼吸系统疾病，常伴有骨骼肌功能异常等全身反应。神经肌肉电刺激是肺康复锻炼治疗的一种手段，已经在小范围内应用于COPD急性加重患者早期的康复治疗。其主要是针对膈肌的刺激，常用的方法有膈肌体内起搏及体外起搏。电刺激通过激活肌纤维运动单元和脊髓神经元再下调运动神经而发挥作用，使特定的肌群被动地节律性收缩；电刺激还改善肌肉的血液循环和淋巴回流，保证肌肉的正常代谢等作用，延迟其萎缩。本文介绍COPD急性加重期患者膈肌功能异常及相关机制、神经肌肉电刺激对膈肌的治疗作用以及方法学，旨在提高神经肌肉电刺激的认识，促进COPD康复治疗技术的发展。Chronic obstructive pulmonary disease （COPD） is a common respiratory disease in China, constantly accompanying some general reaction like skeletal muscle dysfunction. Neuromuscular electrical stimulation is a kind of pulmonary rehabilitation, which has applyed to curing patients of early acute exacerbation of COPD on a small scale. It usually contains implanted diaphragm pecemaker and external diaphragm pacemaker, both of which are aim at diaphragm. The electrical stimulation works through activating muscle fiber motoneuron and lower motor neuron of spinal, nearons,driving the specific muscle group into rhythmic contraction passively. In addition, the electrical stimulation improves blood circulation and lymphatic return of muscle group,assuring normal metabohsm and delaying amyotrophy. This article introduces skeletal muscle dysfunction and its related mechanism of AECOPD patients, as well as how neuromuscular electrical stimulation help curing diaphragmatic atrophy and the specific methods, intending to advance the cognition of neuromuscular electrical stimulation and promoting the development of COPD treatment.

关 键 词：慢性阻塞性肺疾病 骨骼肌功能异常 神经肌肉电刺激 

分 类 号：R563.9[医药卫生—呼吸系统]