摘要
目的:观察体外膈肌起搏(EDP)联合电动起立床对卒中后气管切开患者肺功能的影响,评定其临床疗效。方法:选取60例卒中后气管切开患者,按随机数字表法分成对照组和观察组各30例。对照组在常规药物治疗及护理基础上予以电动起立床治疗,观察组在对照组基础上加用EDP治疗,2组均治疗4周。比较2组治疗前、治疗4周后氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、膈肌移动度(DE)、临床肺部感染评分(CPIS)及临床症状改善有效率。结果:治疗1个月后,2组的PaO_(2)均高于治疗前(P<0.01),PaCO_(2)均低于治疗前(P<0.01);治疗后,观察组的PaO_(2)高于对照组(P<0.01),而PaCO_(2)治疗后2组之间差异无统计学意义。治疗1个月后,2组的DE均高于治疗前(P<0.01),而CPIS均较治疗前降低(P<0.05);治疗后,观察组的DE高于对照组(P<0.01),观察组的CPIS低于对照组(P<0.01)。治疗后,观察组总有效率明显高于对照组(P<0.05)。结论:EDP联合电动起立床能够有效改善卒中后气管切开患者的血气分析指标,改善受损的膈肌功能,同时减轻肺感染,提高临床治疗有效率。
Objective:To observe the effects of external diaphragm pacemaker(EDP)and electric rising bed on pulmonary function in patients with post-stroke tracheotomy and evaluate the clinical efficacy.Methods:All 60 patients with post-stroke tracheotomy were selected and divided into control group and observation group with 30 patients in each group according to a random number table.The control group was treated with electric standing bed on the basis of conventional drug therapy and nursing,and the observation group was treated with EDP on the basis of the control group.Both groups were treated for 4 weeks.Blood gas analysis index(PaO_(2),PaCO_(2)),diaphragm mobile degrees(diaphragmatic excursion,DE),clinical pulmonary infection score(CPIS)and the effective rate of clinical symptom improvement were compared between two groups.Results:After 1 month of treatment,PaO_(2)in control group and observation group was higher than that before treatment(P<0.05),while PaCO_(2)in control group and observation group was lower than before treatment(P<0.05).After 1 month of treatment,PaO_(2)in the observation group was higher than that in the control group(P<0.05),but there was no significant difference in PaCO_(2)between the two groups(P>0.05).After 1 month of treatment,DE in control group and observation group was higher and CPIS was lower than before treatment(P<0.05).After 1 month of treatment,DE in the observation group was higher and CPIS was lower than in the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).Conclusion:In vivo EDP combined with electric standing bed can effectively improve the blood gas analysis index of patients with tracheotomy after stroke,improve the damaged diaphragm function,reduce lung infection,and improve the clinical efficiency.
作者
孙美玲
王欣
李虎
王晓娜
路伟
刘枫
郭太平
Sun Meiling;Wang Xin;Li Hu(Shandong Provincial Third Hospital,Jinan 250031,China)
出处
《中国康复》
2023年第5期264-267,共4页
Chinese Journal of Rehabilitation
基金
山东省中医药科技项目(2021M198)。
关键词
体外膈肌起搏
电动起立床
肺功能
膈肌移动度
external diaphragm pacemaker
electric rising bed
lung function
diaphragmatic excursion
