体外膈肌起搏器联合电动站立床对脑卒中机械通气患者肺功能的影响  

The Effect of Extracorporeal Diaphragm Pacemaker Combined with Electric Standing Bed on Lung Function in Stroke Patients with Mechanical Ventilation

作　　者：毛珍珠 凌颜 MAO Zhen-zhu;LIN Yan(Department of Neurology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院神经内科,南昌330006

出　　处：《实用临床医学（江西）》2024年第6期90-93,共4页Practical Clinical Medicine

基　　金：江西省卫健委科技计划项目(202310550)。

摘　　要：目的探讨体外膈肌起搏器(EDP)联合电动站立床对脑卒中机械通气患者肺功能的影响。方法选取2022年4月至2023年10月南昌大学第二附属医院神经内科重症监护室收治的90例重症脑卒中机械通气患者,按随机数字表发将患者分为站立床组、联合组和对照组,各30例。对照组给予常规治疗及护理干预,站立床组在对照组基础上给予电动站立床训练,联合组在对照组的基础上给予EDP+电动站立床训练。比较3组机械通气时间以及治疗14 d后的氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))及膈肌移动度。结果治疗后,联合组机械通气时间明显短于站立床组和对照组(均P<0.001);站立床组机械通气时间与对照组比较差异无统计学意义(P>0.05)。联合组PaO_(2)显著高于站立床组及对照组,而PaCO_(2)显著低于站立床组及对照组(均P<0.001);站立床组PaO_(2)高于对照组(P=0.041),2组PaCO_(2)比较差异无统计学意义(P>0.05)。结论EDP联合电动站立床有利于促进脑卒中机械通气患者的膈肌功能及肺功能的恢复,缩短机械通气时间。Objective To explore the effect of extracorporeal diaphragmatic pacemaker(EDP)combined with electric standing bed on lung function in stroke patients undergoing mechanical ventilation.Methods A total of 90 severe stroke patients with mechanical ventilation admitted to the neurological intensive care unit of the Second Affiliated Hospital of Nanchang University from April 2022 to October 2023 were selected and divided into a standing bed group,a combination group,and a control group according to the random number table method,with 30 patients in each group.The control group received routine treatment and nursing intervention;the standing bed group received electric standing bed training on the basis of the control group;the combination group received extracorporeal diaphragmatic pacemaker plus electric standing bed training on the basis of the control group.The mechanical ventilation time,oxygen partial pressure(PaO_(2)),carbon dioxide partial pressure(PaCO_(2)),and diaphragmatic mobility after 14 days of treatment were compared among the 3 groups.Results After treatment,the mechanical ventilation time in the combination group was significantly shorter than that in the standing bed group and the control group(both P<0.001);there was no statistically significant difference in the mechanical ventilation time between the standing bed group and the control group(P>0.05).The PaO_(2) in the combination group was significantly higher than that in the standing bed group and the control group,while the PaCO_(2) was significantly lower than that in the standing bed group and the control group(both P<0.001).The PaO_(2) in the standing bed group was higher than that in the control group(P=0.041),but there was no statistically significant difference in PaCO_(2) between the two groups(P>0.05).Conclusion The extracorporeal diaphragm pacemaker,when combined with an electric standing bed,may effectively facilitate the recovery of diaphragmatic and pulmonary functions,thereby reducing mechanical ventilation time in stroke patients

关 键 词：体外膈肌起搏器 电动站立床 脑卒中 机械通气 康复 

分 类 号：R472.2[医药卫生—急诊医学]