摘要
目的 探究早期活动联合电刺激神经肌肉用于改善重症肺炎重症监护室获得性衰弱(ICU-AW)患者的效果。方法 选取150例上海市某三甲医院急诊重症监护室(EICU)入住的重症肺炎引发的ICU-AW患者作为研究对象,随机分为对照组(75例)和联合组(75例)。其中对照组给予早期活动,联合组给予早期活动联合电刺激神经肌肉。比较2组机械通气恢复情况(ICU住院时间、机械通气时间、脱机拔管率、ICU转出率)、肺功能[用力肺活量(FVC)、第1s用力呼气容积(FEV1)/FVC、最大吸气末压力(MIP)]、肌力[医学研究理事会(MRC)评分]、疾病严重程度[急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)]及并发症发生情况。结果 联合组ICU住院时间、机械通气时间明显低于对照组(P<0.05);与干预前比较,2组干预后FVC、FEV1/FVC、MIP及MRC评分均明显升高(P<0.05),且与对照组比较,联合组明显升高(P<0.05);2组APACHEⅡ评分均明显降低(P<0.05),且与对照组比较,联合组明显降低(P<0.05);联合组并发症发生率(9.33%)明显低于对照组(24.00%)(P<0.05)。结论 早期活动联合电刺激神经肌肉用于重症肺炎ICU-AW患者可有效促进机体恢复,提高肺功能,安全有效。
Objective To investigate the effect of early activity combined with electrical stimulation of neuromuscular system in improving intensive care unit(ICU)-acquired weakness(ICU-AW)patients with severe pneumonia.Methods A total of 150 patients with ICU-AW caused by severe pneumonia admitted to emergency intensive care unit(EICU)in a tertiary hospital in Shanghai were enrolled as the study subjects,and randomly divided into control group(75 cases)and combined group(75 cases).The control group took early exercise,and the combination group was given early exercise plus electrical stimulation of neuromuscular system.The recovery from mechanical ventilation(ICU length of stay,duration of mechanical ventilation,weaning extubation rate,ICU rollout rate),lung function[forced vital capacity(FVC),forced expiratory volume in the 1 s(FEV1)/FVC,massive inspiratory pressure(MIP)],muscle strength[Medical Research Council(MRC)score],disease severity[acute physiology and chronic health evaluationⅡ(APACHEⅡ)],and complications were compared between the two groups.Results The ICU length of stay and mechanical ventilation time in the combined group were significantly lower than those in the control group(P<0.05).After intervention,FVC,FEV1/FVC,MIP and MRC scores in the two groups were significantly increased(P<0.05),and compared with the control group,the combined group was significantly increased(P<0.05).After intervention,APACHEⅡscore was significantly reduced in the two groups(P<0.05),and compared with the control group,APACHEⅡscore in combined group were significantly reduced(P<0.05).The complication rate in the combined group(9.33%)was significantly lower than that of control group(24.00%)(P<0.05).Conclusions Early exercise combined with neuromuscular electrical stimulation in patients with severe pneumonia ICU-AW can effectively promote recovery of patients because of improved lung function.This therapy is proved to be be safe and effective.
作者
陆云霞
冯悦
姜金霞
杨帅
LU Yunxia;FENG Yue;JIANG Jinxia;YANG Shuai(School of Medicine,Tongji University,Shanghai 200092;Emergency Intensive Care Unit(EICU),the 10th People′s Hospital Affiliated to Tongji University,Shanghai 200072;Emergency Department,the 10th People′s Hospital Affiliated to Tongji University,Shanghai 200072;Rehabilitation Department,Shanghai Institute of Traumatology and Orthopedics,Shanghai 200020,China)
出处
《基础医学与临床》
2024年第2期242-246,共5页
Basic and Clinical Medicine
基金
上海市卫生健康委员会科研课题(2020220269)。
关键词
ICU获得性衰弱
重症肺炎
电刺激神经肌肉
早期活动
ICU acquired weakness
severe pneumonia
electrical stimulation of neuromuscular system
early exercise
