摘要
目的:观察超声指导穴位电刺激对ICU机械通气患者膈肌功能障碍的疗效。方法:将52例患者随机分为观察组(26例,剔除3例)和对照组(26例)。所有患者均采用常规支持对症治疗,观察组在常规治疗基础上,予穴位电刺激疗法,穴取章门、大包、脾俞、肾俞等,每次30 min,每天3次,疗程为7d。以膈肌呼吸变异度(TFdi)为指标,指导刺激强度的个体化设置及效果判定,并观察两组患者机械通气时间、住ICU时间、总住院时间、住院病死率、再插管事件发生率差异。结果:观察组机械通气时间短于对照组(P<0.05)。两组住ICU时间、总住院时间比较,差异无统计学意义(P>0.05)。住院期间,观察组死亡2例,对照组死亡3例,住院病死率差异无统计学意义(P>0.05)。观察组再插管事件1例,对照组8例(P<0.05)。使用穴位电刺激是缩短机械通气时间、减少再插管事件的影响因素(P<0.05)。结论:超声指导下穴位电刺激可缓解呼吸机致膈肌功能障碍,减少呼吸机支持时间和再插管事件的发生。
Objective To observe the effect of ultrasound-guided acupoint electrical stimulation on the patients with diaphragmatic dysfunction associated with mechanical ventilation in ICU.Methods Fifty-two patients were randomly divided into an observation group(26 cases,3 cases dropping)and a control group(26 cases).Conventional treatment was given to all patients.On the basis of conventional treatment,acupoint electrical stimulation therapy was applied at Zhangmen(LR 3),Dabao(SP 21),Pishu(BL 20),Shenshu(BL 23),etc.In the observation group,the treatment was given for 30 min each time,3 times a day for 7 days.Diaphragm thickening fraction(Tfdi)was used as an index to guide the individualized setting of stimulation intensity and judge the effect,and the difference of mechanical ventilation time,ICU time,total hospitalization time,hospital mortality and reintubation rate between the two groups were observed.Results The mechanical ventilation time in the observation group was shorter than that in the control group(P<0.05).There was no significant difference in the ICU time and total hospitalization time between the two groups(P>0.05).During hospitalization,2 patients died in the observation group and 3 patients died in the control group,there was no significant difference in hospital mortality(P>0.05).One patient in the observation group was reintubated and 8 patients in the control group(P<0.05).The use of acupoint electrical stimulation was a factor in shortening the mechanical ventilation time and reducing the reintubation events(P<0.05).Conclusion Ultrasound-guided acupoint electrical stimulation can relieve ventilator-induced diaphragmatic dysfunction,reduce ventilator support time and reintubation events.
作者
刘绛云
胡星星
郭立中
LIU Jiang-yun;HU Xing-xing;GUO Li-zhong(Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of CM,Nanjing,210028,Jiangsu Province,China;Nanjing University of CM)
出处
《中国针灸》
CAS
CSCD
北大核心
2019年第9期913-917,共5页
Chinese Acupuncture & Moxibustion
基金
江苏省中医药局科技项目:YB2017030
关键词
机械通气
膈肌功能障碍
穴位电刺激
呼吸变异度
mechanical ventilation
diaphragmatic dysfunction
acupoint electrical stimulation
respiratory variability
