早期活动联合电刺激神经肌肉改善重症肺炎患者ICU获得性衰弱

doi:10.16352/j.issn.1001-6325.2024.02.0242

基础医学与临床 ›› 2024, Vol. 44 ›› Issue (2): 242-246.doi: 10.16352/j.issn.1001-6325.2024.02.0242

早期活动联合电刺激神经肌肉改善重症肺炎患者ICU获得性衰弱

陆云霞^1,2, 冯悦^1,2, 姜金霞^3*, 杨帅⁴

1.同济大学医学院,上海 200092; 同济大学附属第十人民医院
2.急诊重症监护室;
3.急诊科,上海 200072;
4.上海市伤骨科研究所康复科,上海 200020

收稿日期:2023-03-06 修回日期:2023-09-22 发布日期:2024-02-05
通讯作者: ^*tiru4985@163.com
基金资助:
上海市卫生健康委员会科研课题(2020220269)

Improvement of early exercise combined with electrical stimulation of neuromuscular system on ICU acquired weakness in patients with severe pneumonia

LU Yunxia^1,2, FENG Yue^1,2, JIANG Jinxia^3*, YANG Shuai⁴

1. School of Medicine, Tongji University, Shanghai 200092;
2. Emergency Intensive Care Unit (EICU);
3. Emergency Department, the 10th People's Hospital Affiliated to Tongji University, Shanghai 200072;
4. Rehabilitation Department, Shanghai Institute of Traumatology and Orthopedics, Shanghai 200020, China

Received:2023-03-06 Revised:2023-09-22 Published:2024-02-05
Contact: ^*tiru4985@163.com

摘要/Abstract

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。

关键词: ICU获得性衰弱, 重症肺炎, 电刺激神经肌肉, 早期活动

Abstract: 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 evaluation Ⅱ (APACHE Ⅱ)], 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, APACHE Ⅱ score was significantly reduced in the two groups(P＜0.05), and compared with the control group, APACHE Ⅱ score 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.

Key words: ICU acquired weakness, severe pneumonia, electrical stimulation of neuromuscular system, early exercise

中图分类号:

R473.5

陆云霞, 冯悦, 姜金霞, 杨帅. 早期活动联合电刺激神经肌肉改善重症肺炎患者ICU获得性衰弱[J]. 基础医学与临床, 2024, 44(2): 242-246.

LU Yunxia, FENG Yue, JIANG Jinxia, YANG Shuai. Improvement of early exercise combined with electrical stimulation of neuromuscular system on ICU acquired weakness in patients with severe pneumonia[J]. Basic & Clinical Medicine, 2024, 44(2): 242-246.

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早期活动联合电刺激神经肌肉改善重症肺炎患者ICU获得性衰弱

Improvement of early exercise combined with electrical stimulation of neuromuscular system on ICU acquired weakness in patients with severe pneumonia

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