| 摘要: |
| 目的:观察腹部电刺激与膈肌起搏治疗仪联合应用对脑外伤后气管切开患者气道廓清能力及拔管率的影响。方法:选取80例脑外伤气管切开患者为对象分为观察组、对照组,每组40例。对照组以膈肌起搏治疗仪治疗干预,观察组在对照组基础上增加腹部电刺激治疗。评估两组患者的咳嗽排痰能力指标、膈肌超声指标、肺通气功能、拔管时间、拔管成功率、住院时间、预后康复质量评分。结果:治疗后,两组非自主咳嗽峰流速(ICPF)、半定量咳嗽强度评分(SCSS)、排痰量,膈肌超声指标,肺通气第1秒用力呼气量(FEV1)、呼气峰流速值(PEF)、用力肺活量(FVC)、最大通气量(MVV), 生活质量综合评定问卷(GQOLI-74)、简易智力状态检查量表(MMSE)、格拉斯哥预后评分量表(GOS)评分均高于治疗前,且观察组患者的非自主咳嗽峰流速(ICPF)、半定量咳嗽强度评分(SCSS)、排痰量均高于对照组(P<0.05)。治疗后,观察组膈肌移动度、膈肌厚度、膈肌增厚分数均高于对照组(P<0.05)。治疗后,观察组肺通气功能指标包括第1秒用力呼气量(FEV1)、呼气峰流速值(PEF)、用力肺活量(FVC)、最大通气量(MVV)均高于对照组(P<0.05)。治疗后,观察组拔管成功率高于对照组,拔管时间、住院时间小于对照组(P<0.05)。治疗后,观察组生活质量综合评定问卷(GQOLI-74)、简易智力状态检查量表(MMSE)、格拉斯哥预后评分量表(GOS)评分均高于对照组(P<0.05)。结论:腹部电刺激联合膈肌起搏治疗仪对脑外伤后气管切开患者气道廓清能力显著,能够提高患者的咳嗽排痰能力,增强患者的膈肌运动功能,提高患者肺通气功能,提高患者拔管成功率,改善患者的预后效果评分。 |
| 关键词: 脑外伤 气管切开 腹部电刺激 膈肌起搏治疗仪 气道廓清能力 拔管率 |
| DOI： |
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| 基金项目:江苏省卫生健康委医学科研立项项目（S2022060） |
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| The influence of abdominal electrical stimulation combined with diaphragm pacing therapy device on airway clearance ability and extubation rate in patients with tracheotomy after brain trauma |
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1.Nanjing Lishui People'2.'3.s Hospital;1.Nanjing Lishui People'2.'3.s Hospital
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| Abstract: |
| Objective: To study and explore the effect of abdominal electrical stimulation combined with diaphragmatic pacing therapy on the airway and extubation rate clearance ability with tracheotomy of patients after brain trauma. Method: Select 80 cases of cerebral trauma patients with tracheotomy as object is divided into observation group and control group, 40 cases in each group. The control group was treated and intervened with a diaphragm pacing therapy device. while the observation group received additional abdominal electrical stimulation therapy on the basis of the control group. Evaluate the cough and sputum clearance ability indicators, diaphragmatic ultrasound indicators, pulmonary ventilation function, extubation time, extubation success rate, hospitalization time, and prognosis rehabilitation quality score of two groups of patients. Result: Before treatment, there was no statistically significant difference in the cough and sputum output indicators between the two groups of patients (P>0.05). After treatment, the observation group non spontaneous cough peak flow velocity (ICPF), semi quantitative cough intensity score (SCSS), and sputum output were higher than group control (P<0.05). After treatment, the ultrasound indicators of the diaphragm, including diaphragm movement, diaphragm thickness, and diaphragm thickening score, were observed to be higher than those in the control group (P<0.05). After treatment, the observation group had higher lung ventilation function indicators, including forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEF), forced vital capacity (FVC), and maximum ventilation volume (MVV), compared to the control group (P<0.05).? After treatment, the observation group success rate of extubation was higher than group control, and the extubation time and hospital stay were shorter than those in the control group (P<0.05). After treatment, the quality of life comprehensive assessment questionnaire (GQOLI-74), Mini Mental State Examination (MMSE), and Glasgow Outcome Scale (GOS) scores in the observation group were higher than those in the control group (P<0.05). Conclusion: Abdominal electrical stimulation combined with diaphragmatic pacing therapy has a significant effect on airway clearance in patients with tracheotomy after brain trauma. It can improve the patients" cough and expectoration ability, enhance the diaphragmatic motor function, improve the pulmonary ventilation function, increase the success rate of extubation, and improve the prognosis score of the patients. |
| Key words: Brain injury tracheostomy abdominal electrical stimulation diaphragm pacing device airway clearance ability extubation rate |
