高压氧联合体外膈肌起搏在急性颈髓损伤伴呼吸衰竭患者脱机治疗中的应用  

Application of hyperbaric oxygen combined with external diaphragm pacing in off-line treatment of patients of acute cervical spinal cord injury with respiratory failure

作　　者：陈黎新 汪洋 赖小勇 CHEN Lixin;WANG Yang;LAI Xiaoyong(Department of Critical Care Medicine,Nanchang Mingzhou Rehabilitation Hospital,Jiangxi Province,Nanchang 330039,China)

机构地区：[1]南昌明州康复医院重症医学科,江西南昌330039

出　　处：《中国当代医药》2022年第26期44-47,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220203776)。

摘　　要：目的探讨高压氧(HBO)联合膈肌起搏(EDP)在急性颈髓损伤伴呼吸衰竭患者脱机治疗中的应用效果。方法选取2019年5月至2022年1月南昌明州康复医院收治的50例急性颈髓损伤伴呼吸衰竭患者为研究对象,采用随机数字表法分为对照组与观察组,各25例。对照组给予常规治疗,观察组在对照组的基础上采取HBO联合EDP治疗。两组患者均治疗3周。比较两组患者的脱机成功率、膈肌移动度、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))]及机械通气时间。结果观察组的脱机成功率高于对照组,差异有统计学意义(P<0.05);两组患者治疗前的膈肌移动度、肺功能指标比较,差异无统计学意义(P>0.05);观察组患者治疗后的膈肌移动度、FVC、FEV_(1)水平高于对照组,差异有统计学意义(P<0.05);观察组的机械通气时间短于对照组,差异有统计学意义(P<0.05)。结论HBO联合EDP治疗可改善急性颈髓损伤伴呼吸衰竭患者的膈肌移动度、肺功能指标,有效减轻呼吸衰竭,从而提高脱机成功率,缩短机械通气时间。Objective To investigate the effect of hyperbaric oxygen(HBO)combined with external diaphragm pacing(EDP)in off-line treatment of patients of acute cervical spinal cord injury with respiratory failure.Methods A total of 50 patients with acute cervical spinal cord injury and semi-respiratory failure admitted to Mingzhou Rehabilitation Hospital of Nanchang from May 2019 to January 2022 were selected as the study subjects,and they were divided into the control group and the observation group according to random number table method,with 25 cases in each group.The control group was given conventional treatment,and the observation group was treated with HBO combined with EDP.Both groups were treated for 3 weeks.The off-line success rate,diaphragmatic mobility,lung function indexes(forced vital capacity[FVC],forced expiratory volume in one second[FEV_(1)])and mechanical ventilation time were compared between the two groups.Results The off-line success rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the indexes of diaphragm movement and lung function between the two groups before treatment(P>0.05).After treatment,the levels of diaphragm mobility,FVC and FEV_(1) in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The mechanical ventilation time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).Conclusion HBO combined with EDP can improve the diaphragm mobility and lung function indexes of patients with acute cervical spinal cord injury and respiratory failure,effectively relieve respiratory failure,thereby increasing the success rate of weaning and shortening the mechanical ventilation time.

关 键 词：急性颈髓损伤 呼吸衰竭 高压氧 膈肌起搏 脱机成功率 肺功能 

分 类 号：R641[医药卫生—外科学]