摘要
目的探讨神经肌肉电刺激(NMES)对重症监护病房(ICU)机械通气患者肌力及预后的影响。方法选取2020年1月至2021年12月海南省儋州市人民医院ICU收治的106例患者,依据随机数字表法将其分为两组,对照组(53例)接受常规对症治疗和康复训练,观察组(53例)在对照组基础上接受NMES。比较两组机械通气时间、ICU入住时间、住院时间;比较两组入ICU第3天与出ICU时握力、医学研究委员会徒手肌力测定法(MRC)评分、急性生理与慢性健康评估Ⅱ(APACHEⅡ)评分、Barthel指数;比较两组出ICU时ICU-获得性肌无力(ICU-AW)的发生率及28 d内死亡率。结果观察组机械通气时间、ICU入住时间和住院时间短于对照组(P<0.05)。出ICU时,两组患者握力、MRC评分和Barthel指数高于入ICU第3天,且观察组高于对照组(P<0.05);APACHEⅡ评分低于入ICU第3天,且观察组低于对照组(P<0.05)。出ICU时,观察组ICU-AW发生率和28 d内死亡率低于对照组(P<0.05)。结论NMES能有效提高ICU机械通气患者肌力,降低ICU-AW发生率和死亡率,改善患者预后。
Objective To investigate the effect of neuromuscular electrical stimulation(NMES)on muscle strength and prognosis of mechanically ventilated patients in intensive care unit(ICU).Methods A total of 106 patients admitted to ICU of Danzhou People’s Hospital of Hainan Province from January 2020 to December 2021 were selected,and they were divided into two groups according to the random number table method.The control group(53 cases)received routine symptomatic treatment and rehabilitation training,and observation group(53 cases)received NMES on the basis of control group.The mechanical ventilation time,ICU stay time,and hospital stay were compared between two groups;the grip strength,medical research council manual muscle test(MRC)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,and Barthel index were compared between two groups on the 3rd day of ICU admission and on the day of ICU exit;the incidence of ICU-acquired myasthenia(ICU-AW)and the mortality within 28 days were compared between two groups.Results The mechanical ventilation time,ICU stay time,and hospital stay in the observation group were shorter than those in control group(P<0.05).On the day of ICU exit,the grip strength,MRC score and Barthel index in both groups were higher than those on the 3rd day of ICU admission,and observation group was higher than control group(P<0.05);APACHEⅡscore in both groups were lower than those on the 3rd day of ICU admission,and observation group was lower than control group(P<0.05).On the day of ICU exit,the incidence of ICU-AW and mortality within 28 days in observation group were lower than those in control group(P<0.05).Conclusion NMES can effectively improve the muscle strength of ICU patients with mechanical ventilation,reduce the incidence and mortality of ICU-AW,and improve the prognosis of patients.
作者
党辉
陈军
陈伟荣
黎建明
杨菲菲
DANG Hui;CHEN Jun;CHEN Weirong;LI Jianming;YANG Feifei(Department of Rehabilitation Medicine,Danzhou People’s Hospital,Hainan Province,Danzhou 571700,China;Department of Critical Medicine,Danzhou People’s Hospital,Hainan Province,Danzhou 571700,China)
出处
《中国医药导报》
CAS
2022年第31期104-107,共4页
China Medical Herald
基金
海南省卫生健康行业科研项目(21A200343)。
关键词
重症监护病房
获得性肌无力
机械通气
神经肌肉电刺激
预后
Intensive care unit
Acquired myasthenia
Mechanical ventilation
Neuromuscular electrical stimulation
Prognosis
