电针干预呼吸机相关性膈肌功能障碍的临床观察  

Clinical Study of Electroacupuncture on Ventilator-Induced Diaphragmatic Dysfunction

作　　者：耿艳霞[1] 蒋华[1] 吕海[1] 陈栋[1] 陈秋华[1] 周海琪[1] 裴颖皓 原萌谦 Geng Yanxia;Jiang Hua;Lyu Hai;Chen Dong;Chen Qiuhua;Zhou Haiqi;Pei Yinghao;Yuan Mengqian(The Affiliated Hospital of Nanjing Unwersity of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Jiangsu,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏省中医院,江苏南京210029

出　　处：《中国中医急症》2022年第3期490-493,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省中医院创新发展基金专项(Y2018CX05);江苏省中医院创新课题(Y2020CX11)。

摘　　要：目的观察以“治痿独取阳明、培土生金”理论为指导的电针干预呼吸机相关性膈肌功能障碍(VIDD)的疗效。方法将62例VIDD患者随机分为对照组与电针组各31例。对照组接受常规支持治疗,电针组在常规治疗基础上予电针治疗7 d,穴取中府、膻中、曲池、足三里,每日2次,每次30 min。床旁超声测定第1天及第7天的膈肌功能,包括膈肌活动度、膈肌厚度和膈肌厚度变化率,并观察两组患者的撤机时间及第7天撤机成功率。结果电针组第7天膈肌活动度明显高于对照组(P<0.05)。两组患者第7天吸气末膈肌厚度、呼气末膈肌厚度及膈肌厚度变化率比较,差异无统计学意义(P>0.05)。两组患者撤机时间及第7天撤机成功率比较,差异均无统计学意义(P>0.05)。结论电针治疗可提高VIDD患者膈肌活动度,可在一定程度上改善膈肌功能。Objective:To observe the efficacy of electroacupuncture(EA)on ventilator-induced diaphragm dysfunction(VIDD)guided by the theory of"treating atrophy disease to take YangMing Meridian and reinforcing the earth to generate the metal",by dynamically detecting the diaphragm function with ultrasound imaging.Methods:62 patients diagnosed with VIDD were randomly divided into the control group(n=31)and EA group(n=31).Patients of control group only received conventional treatment,while patients of EA group received acupuncture stimulation(twice a day,30 min each time)for 7 days of Zhongfu,Danzhong,Quchi,Zusanli.Bedside ultrasound was used to evaluate diaphragm function on day 1 and day 7,including diaphragmatic excursion,end expiratory thickness(Tee),end inspiratory thickness(Tei),and thickening fraction(TF).Besides,the weaning time and the success rate of weaning on day 7 were also recorded.Results:The diaphragmatic excursion in EA group was significantly higher than that of the control group on day 7(P<0.05).There was no significant difference in Tee,Tei or TF between two groups on day 7(P>0.05).No significant difference was found in the weaning time or weaning success rate on day 7 between two groups(P>0.05).Conclusion:EA can improve diaphragmatic excursion and relieve VIDD to a certain extent.

关 键 词：膈肌功能障碍 机械通气 电针 膈肌超声 

分 类 号：R565[医药卫生—呼吸系统]