适宜性电刺激膈神经联合抗胆碱能药改善慢性阻塞性肺疾病患者膈肌疲劳和肺功能的临床研究  

A clinical study on appropriate electrostimulation of phrenic nerve combined with anti-cholinesterase inhaler to improve the diaphragmatic fatigue relief and pulmonary function in COPD patients

作　　者：张丽丽[1] 薛培丽[1] 邱立志[1] 曾凤英[1] 白金凤[1] 卢江 杨巡 ZHANG Li-li;XUE Pei-li;QIU Li-zhi;ZENG Feng-ying;BAI Jin-feng;LU Jiang;YANG Xun(Department of Respiratory Medicine ,Sichuan University of Science and Technology ,Mianyang 621900, China)

机构地区：[1]四川省科学城医院呼吸内科,四川绵阳621900

出　　处：《实用医院临床杂志》2018年第3期104-107,共4页Practical Journal of Clinical Medicine

基　　金：四川省医学科研青年创新课题计划(编号:Q16063)

摘　　要：目的探讨适宜电刺激膈神经联合抗胆碱能药在改善慢性阻塞性肺疾病(COPD)患者膈肌疲劳和肺功能的临床疗效。方法选取我院80例COPD患者,根据住院先后顺序分为对照组与观察组各40例,均予以抗炎、改善呼吸功能等基础治疗,对照组在此基础上加用抗胆碱脂酶吸入剂,观察组加用EDP-II型体外膈肌起搏器,两组均治疗15d。疗程结束后,检测两组膈肌活动情况及肺功能,同时进行血气分析,评估肺功能改善情况。结果治疗后,对照组膈肌活动度、第一秒用力呼气容积(FEV_1)、第一秒用力呼气容积/用力肺活量(FEV_1/FVC)、最大通气量(MVV)、肺总量(TLC)、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)均显著低于观察组,COPD相关生活质量评分(CAT)显著高于观察组,6 min步行距离显著低于观察组(P<0.05)。结论适宜电刺激膈神经联合抗胆碱能药可提高COPD患者肺功能改善情况,并有效缓解膈肌疲劳,临床疗效较好。Objective To explore the clinical efficacy of appropriate electrostimulation of phrenic nerve combined with anticholinesterase inhaler in improvement of diaphragmatic fatigue relief and pulmonary function in patients with COPD. Methods Eighty COPD patients were divided into control and observation groups according to the admission sequence,40 in each group.All patients were given the anti-inflammation,respiratory function improvement and other basic treatment.The control group was additionally given the anti-cholinesterase inhaler while the observation group was additionally given the EDP-II type of vitro diaphragm pacemaker.The treatment course was 15 d.After the end of treatment,the diaphragmatic muscle activity and the pulmonary function was detected.At the same time,the blood gas analysis was made to assess the pulmonary function improvement.Results After treatment,the diaphragm activity and the levels of FEV1,FEV1/FVC,MVV,TLC,PaO2 and PaCO2 in the control group was significantly lower than those in the observation group.The CAT in the control group was significantly higher than that in the observation group,and the 6-min walking distance was significantly lower than that in the observation group（ P〈0. 05）.Conclusion Appropriate electrostimulation of phrenic nerve combined with anti-cholinesterase inhaler can improve the lung function of COPD patients and effectively relieve the diaphragmatic fatigue with good clinical efficacy.

关 键 词：膈神经 抗胆碱能药 COPD 膈肌疲劳 

分 类 号：R563[医药卫生—呼吸系统]