Abstract：Objective To investigate the effect of neuromuscular electrical stimulation (NMES) on muscle strength and prognosis of mechanically ventilated patients in intensive care unit (ICU). Methods A total of 106 patients admitted to ICU of Danzhou People’s Hospital of Hainan Province from January 2020 to December 2021 were selected, and they were divided into two groups according to the random number table method. The control group (53 cases) received routine symptomatic treatment and rehabilitation training, and observation group (53 cases) received NMES on the basis of control group. The mechanical ventilation time, ICU stay time, and hospital stay were compared between two groups; the grip strength, medical research council manual muscle test (MRC) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and Barthel index were compared between two groups on the 3rd day of ICU admission and on the day of ICU exit; the incidence of ICU-acquired myasthenia (ICU-AW) and the mortality within 28 days were compared between two groups. Results The mechanical ventilation time, ICU stay time, and hospital stay in the observation group were shorter than those in control group (P ＜ 0.05). On the day of ICU exit, the grip strength, MRC score and Barthel index in both groups were higher than those on the 3rd day of ICU admission, and observation group was higher than control group (P ＜ 0.05); APACHE Ⅱ score in both groups were lower than those on the 3rd day of ICU admission, and observation group was lower than control group (P ＜ 0.05). On the day of ICU exit, the incidence of ICU-AW and mortality within 28 days in observation group were lower than those in control group (P ＜ 0.05). Conclusion NMES can effectively improve the muscle strength of ICU patients with mechanical ventilation, reduce the incidence and mortality of ICU-AW, and improve the prognosis of patients.
党辉1 陈军2 陈伟荣1 黎建明1 杨菲菲1. 神经肌肉电刺激对重症监护病房机械通气患者肌力及预后的影响[J]. 中国医药导报, 2022, 19(31): 104-107.
DANG Hui1 CHEN Jun2 CHEN Weirong1 LI Jianming1 YANG Feifei1. Effect of neuromuscular electrical stimulation on muscle strength and prognosis of mechanically ventilated patients in intensive care unit. 中国医药导报, 2022, 19(31): 104-107.
[1] Fan E，Cheek F，Chlan L，et al. An official American Thoracic Society Clinical Practice guideline：the diagnosis of intensive care unit-acquired weakness in adults [J]. Am J Respir Crit Care Med，2014，190（12）：1437-1446.
[2] 中华医学会重症医学分会.中国成人ICU镇痛和镇静治疗指南[J].中华危重病急救医学，2018，30（6）：497-514.
[3] 李叶青，席修明，姜利，等.机械通气患者ICU获得性肌无力危险因素分析[J].中华危重病急救医学，2019，31（11）：1351-1356.
[4] 崔越亭，王蓓.ICU获得性肌无力病因和发病机制的研究进展[J].临床肺科杂志，2021，26（3）：460-464，470.
[5] 张迎，张婷婷，强杰，等.早期康复在ICU获得性肌无力患者中的应用价值[J].现代中西医结合杂志，2021，30（1）：92-95.
[6] 胡燕，李冬英，胡晓莹，等.早期活动对机械通气病人ICU获得性肌无力影响的累计Meta分析及试验序贯分析[J].护理研究，2020，34（18）：3190-3196.
[7] 余勰，张贵方，陈雪梅，等.中西医治疗ICU获得性衰弱研究进展[J].河南中医，2021，41（11）：1765-1772.
[8] 王洁，彭剑英，周佩洋，等.神经肌肉电刺激在全脑血管造影术后患者中的应用[J].介入放射学杂志，2021，30（12）：1292-1295.
[9] 程洁，孔佳佳，王瑞，等.下肢部位神经肌肉电刺激对ICU机械通气患者影响的Meta分析[J].中华危重病急救医学，2021，33（10）：1243-1248.
[10] Paternostro-Sluga T，Grim-Stieger M，Posch M，et al. Reliability and validity of the Medical Research Council（MRC）scale and a modified scale for testing muscle strength in patients with radial pals [J]. J Rehabil Med，2008，40（8）：665-671.
[11] Knaus WA，Draper EA，Wagner DP，et al. APACHE Ⅱ：a severity of disease classification system [J]. Crit Care Med，1985，13（10）：818-829.
[12] Shah S，Vanclay F，Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation [J]. J Clin Epidemiol，1989，42（8）：703-709.
[13] 谢永鹏，钱颖，袁刚，等.竖脊肌横截面积联合血清GDF- 15对ICU机械通气患者获得性肌无力诊断及预后评估价值研究[J].中华急诊医学杂志，2020，29（8）：1059-1065.
[14] 邓茂林，杨卓，邓湘辉.TNF-α、IL-1β和IL-6对机械通气患者ICU获得性肌无力诊断和预后的意义[J].国际神经病学神经外科学杂志，2020（2）：157-161.
[15] 王晓敏，朱晓萍.ICU获得性肌无力的发生和诊断及治疗[J].中华危重病急救医学，2020，32（8）：1020-1024.
[16] 刘芙蓉，敖雪，刘蕾，等.ICU获得性肌无力动物模型的建立及病理机制探讨[J].医学研究生学报，2020，33（3）：264-269.
[17] 杨梦璇，黄维，苏建华，等.神经肌肉电刺激治疗在加速重症监护病房患者康复方面的应用进展[J].中国康复医学杂志，2021，36（3）：370-374.
[18] 谌绍林，蒋玉兰，禹斌，等.经皮神经肌肉电刺激对COPD机械通气患者ICU-AW的预防效果[J].中华危重病急救医学，2019，31（6）：709-713.
[19] de Campos Biazon TMP，Libardi CA，Junior JCB，et al. The effect of passive mobilization associated with blood flow restriction and combined with electrical stimulation on cardiorespiratory safety，neuromuscular adaptations，physical function，and quality of life in comatose patients in an ICU：a randomized controlled clinical trial [J]. Trials，2021，22（1）：969.
[20] Toth MJ，Tourville TW，Voigt TB，et al. Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction：A Randomized，Sham-Controlled，Blinded Trial [J]. Am J Sports Med，2020， 48（10）：2429-2437.
[21] 朱春艳，刘宝，杨田军，等.早期康复理疗对危重症患者肌肉质量和功能的影响[J].中华危重病急救医学，2018， 30（6）：569-572.
[22] 周瑸，严洪立，黄林科，等.不同神经肌肉电刺激方法对肌肉疲劳影响的研究[J].生命科学仪器，2021，19（2）：35-39.
[23] 黄金秀，周文姬，孙明英，等.头皮针联合神经肌肉电刺激和康复训练治疗脑卒中恢复期咽期吞咽障碍的效果[J].中国医药导报，2021，18（23）：76-79.
[24] 赵璇，韩娟，马佳佳，等.ICU获得性衰弱病人肌力恢复状况及影响因素分析[J].护理研究，2022，36（5）：795-800.
[25] 邢小贝，孙恒聪，林道冠，等.电刺激联合运动干预对偏瘫肌张力增高的影响[J].中国实用神经疾病杂志，2021， 24（13）：1152-1157.
[26] 邱昱，姜利，席修明.机械通气患者ICU获得性肌无力早期发病率及预后研究[J].中华危重病急救医学，2019， 31（7）：821-826.
京公网安备 11010502046598号