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| 体外膈肌起搏器联合气道廓清技术对气管切开患者肺功能及拔管成功率的临床研究 |
| Clinical study of extracorporeal diaphragm pacemaker combined with airway clearance technology on pulmonary function and success rate of extubation in patients with tracheotomy |
| 投稿时间：2024-04-08 修订日期：2025-09-23 |
| DOI： |
| 中文关键词: 体外膈肌起搏器；气道廓清技术；气管切开；肺功能；拔管 |
| 英文关键词: Extracorporeal diaphragm pacemaker; Airway clearance technology; Tracheotomy; Pulmonary function; extubation |
| 基金项目:济宁市重点研发计划项目（2023YXNS179）；济宁医学院附属医院“苗圃”科研课题（MP--ZD-2022-002） |
| 作者 | 单位 | 邮编 | | 霍飞翔 | 济宁医学院附属医院 | 272000 | | 邵士光 | 济宁医学院附属医院 | | | 孙亚鲁 | 济宁医学院附属医院 | | | 杨帅 | 济宁医学院附属医院 | | | 张洪蕊* | 济宁医学院附属医院 | |
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| 中文摘要: |
| 目的 探讨体外膈肌起搏器联合气道廓清技术对气管切开患者肺功能及拔管成功率的影响。方法 将符合纳入标准的66例气管切开患者随机分为观察组和对照组，每组33例，在治疗期间观察组和对照组各有3例患者脱落，两组患者均给予常规气道廓清技术，观察组在气道廓清技术的基础上增加体外膈肌起搏器治疗，观察周期为6周，分别在治疗前、治疗3周及6周后使用非自主咳嗽峰流速（ICPF）、临床肺部感染评分（CPIS）、膈肌活动度、气管套管拔管时间和拔管成功率比较临床疗效的差异。结果 治疗前，两组患者的ICPF、CPIS、膈肌活动度组间差异无统计学意义（P＞0.05），治疗3周、6周后，观察组的ICPF、CPIS、膈肌活动度改善程度明显优于对照组，差异具有统计学意义（P<0.05）；观察组的拔管时间比对照组明显缩短（P<0.05）；且试验组的拔管成功率为86.7%，明显高于对照组的63.3%，差异具有统计学意义（P<0.05）。结论 体外膈肌起搏器联合气道廓清技术能有效改善气管切开患者的肺功能，缩短气管套管拔除时间并提高拔管成功率。 |
| 英文摘要: |
| Objective: To investigate the effect of extracorporeal diaphragm pacemaker combined with airway clearance technology on lung function and success rate of extubation in patients with tracheotomy. Methods 66 patients with tracheotomy who met the inclusion criteria were randomly divided into the observation group and the control group, with 33 cases in each group. During treatment, 3 patients in the observation group and the control group fell out, and patients in both groups were given conventional airway clearance technology. The observation group was treated with external diaphragm pacemaker on the basis of airway clearance technology, and the observation period was 6 weeks. Involuntary cough peak flow rate (ICPF), clinical pulmonary infection score (CPIS), diaphragm activity, tracheal tube extubation time and success rate were used to compare the clinical efficacy before treatment, 3 weeks and 6 weeks after treatment. Results Before treatment, there was no statistical significance in ICPF, CPIS and diaphragmatic activity between the two groups (P > 0.05). After 3 and 6 weeks of treatment, the improvement of ICPF, CPIS and diaphragmatic activity in the observation group was significantly better than that in the control group, with statistical significance (P<0.05). The extubation time of the observation group was significantly shorter than that of the control group (P<0.05). The success rate of extubation in experimental group was 86.7%, which was significantly higher than that in control group (63.3%), and the difference was statistically significant (P<0.05). Conclusion Extracorporeal diaphragm pacemaker combined with airway clearance can effectively improve lung function in patients with tracheotomy, shorten the time of tracheal tube extraction and increase the success rate of extubation. |
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