序贯健肌操联合体外膈肌起搏干预在无创机械通气患者中的应用  

Application of sequential muscle exercise combined with extracorporeal diaphragm pacing intervention in patients with non-invasive mechanical ventilation

作　　者：王文敏 冯岩[1] WANG Wenmin;FENG Yan(Neurological Intensive Care Unit,Zhengzhou First People′s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第一人民医院神经重症监护室,郑州450000

出　　处：《中国临床护理》2024年第4期218-221,共4页Chinese Clinical Nursing

摘　　要：目的探讨序贯健肌操联合体外膈肌起搏(external diaphragmatic pacing,EDP)在无创机械通气患者中的应用效果。方法选取2021年5月-2023年5月在郑州市第一人民医院神经重症监护室治疗的108例无创机械通气患者,将其随机分为对照组和观察组,各54例。对照组予以EDP干预,观察组在对照组基础上行序贯健肌操干预。比较2组干预前后膈肌功能、血气分析指标、撤机成功率、机械通气时间、ICU住院时间。结果干预后,观察组膈肌移动度(DE)、吸气末膈肌厚度、呼气末膈肌厚度、动脉氧分压(PaO_(2))、氧合指数及撤机成功率均高于对照组(t=-3.818,P<0.001;t=-2.186,P=0.031;t=-2.644,P=0.009;t=-2.780,P=0.006;t=-2.241,P=0.027;χ^(2)=4.267,P=0.039),机械通气时间、ICU住院时间均短于对照组(t=6.227,P<0.001;t=3.739,P<0.001),二氧化碳分压(PaCO_(2))低于对照组(t=6.458,P<0.001)。结论序贯健肌操联合EDP干预在无创机械通气患者中应用效果较好,能缩短患者机械通气时间,提高撤机成功率,改善膈肌功能。Objective To explore the effect of sequential muscle exercise combined with external diaphragm pacing(EDP)intervention on patients with non-invasive mechanical ventilation.Methods A total of 108 patients who underwent non-invasive mechanical ventilation in the hospital between May 2021 and 2023 were selected and randomly divided into a control group and an observation group,each of 54.Both groups were given EDP intervention,while the observation group was additionally provided with sequential muscle exercise.Before and after the intervention,the diaphragmatic function,blood gas indexes,success rate of weaning,duration of mechanical ventilation and ICU stay were compared between the two groups.Results The diaphragmatic excursion(DE),end-inspiratory diaphragmatic thickness(EIDT),end-expiratory diaphragmatic thickness(EEDT),arterial partial pressure of oxygen(PaO_(2)),oxygenation index(OI)and success rate of ventilator weaning in the observation group were significantly higher than that of the control group(t=-3.818,P<0.001;t=-2.186,P=0.031;t=-2.644,P=0.009;t=-2.780,P=0.006;χ^(2)=4.267,P=0.039;t=-2.241,P=0.027),while the mechanical ventilation duration and length of ICU stay were significantly shorter than the latter(t=6.227,P<0.001;t=3.739,P<0.001),and the PaCO_(2)was significantly lower than the latter(t=6.458,P<0.001).Conclusion The combined intervention of sequential muscle exercise and EDP is effective for patients undergoing non-invasive mechanical ventilation,which can shorten the time to ventilation,increase the success rate of weaning and improve the patients′diaphragmatic function.

关 键 词：序贯健肌操 体外膈肌起搏 无创机械通气 膈肌功能 

分 类 号：R473.5[医药卫生—护理学]