| 霍飞翔,邵士光,徐海东,贾万光,孙亚鲁,张洪蕊.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[J].济宁医学院学报,2025,48(5):417-422 |
| 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 |
| The impact of extracorporeal diaphragm pacemaker combined with airway clearance technology on pulmonary function and success rateof extubation in patients with tracheotomy |
| 投稿时间：2024-10-21 |
| DOI：10.3969/j.issn.1000-9760.2025.05.007 |
| 中文关键词: 体外膈肌起搏器;气道廓清技术;气管切开;拔管 |
| 英文关键词: Extracorporeal diaphragm pacemaker;Airway clearance technology;Tracheotomy;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 | E-mail | | 霍飞翔 | 济宁医学院附属医院康复医学科, 济宁 272000 | | | 邵士光 | 济宁医学院附属医院康复医学科, 济宁 272000 | | | 徐海东 | 济宁医学院附属医院康复医学科, 济宁 272000 | | | 贾万光 | 济宁医学院附属医院康复医学科, 济宁 272000 | | | 孙亚鲁 | 济宁医学院附属医院康复医学科, 济宁 272000 | | | 张洪蕊 | 济宁医学院附属医院康复医学科, 济宁 272000 | 18305370300@163.com |
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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例患者退出研究。2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)、静息下膈肌活动度、气管套管拔管时间和拔管成功率比较2组临床疗效的差异。结果 2组患者的ICPF、CPIS、静息下膈肌活动度的时间效应、组间效应、交互效应均具有统计学意义(P＜0.05)；与治疗前比较，2组患者治疗后的ICPF、CPIS、静息下膈肌活动度均较前改善(P＜0.05)；且治疗3周、6周后，观察组的ICPF、CPIS、静息下膈肌活动度优于对照组，差异具有统计学意义(P＜0.05)；观察组拔管时间比对照组缩短(t=6.405，P＜0.05)；且观察组拔管成功率为86.7%，高于对照组63.3%(χ2=4.356，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 effects of combined diaphragmatic pacing and airway clearance techniques on pulmonary function and extubation success rates in tracheostomy patients. Methods Sixty-six tracheostomised patients meeting inclusion criteria were randomly assigned to an observation group and a control group (n=33). During the study period, three patients dropped out from each group. Both groups received conventional airway clearance techniques. The observation group additionally received extracorporeal diaphragmatic pacing therapy alongside airway clearance techniques. The observation period lasted 6 weeks. Clinical efficacy was assessed by comparing involuntary cough peak flow rate (ICPF), clinical pulmonary infection score (CPIS), resting diaphragmatic mobility, tracheal tube removal time, and extubation success rate before treatment, at 3 weeks, and at 6 weeks post-treatment. Results Time effects, between-group effects, and interaction effects for ICPF, CPIS, and resting diaphragmatic mobility were statistically significant in both groups (P < 0.05). Compared with pre-treatment levels, post-treatment ICPF, CPIS, and resting diaphragmatic mobility improved in both groups (P < 0.05). Furthermore, at 3 and 6 weeks post-treatment, the observation group demonstrated significantly superior ICPF, CPIS, and resting diaphragmatic mobility compared to the control group (P < 0.05). The observation group exhibited markedly shorter extubation times than the control group (t=6.405, P < 0.05). Furthermore, the extubation success rate in the observation group was 86.7%, markedly higher than the control group's 63.3% (χ2=4.356, P < 0.05). Conclusion The combination of an external diaphragmatic pacing device with airway clearance techniques effectively improves pulmonary function in tracheostomised patients, shortens tracheal tube removal time, and enhances extubation success rates. |
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