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姚叶林,陈 康,陶金好,陈伟明,秦 妍,王素娟.超声引导下对撤机失败儿童进行膈肌手法干预的疗效观察[J].中国康复医学杂志,2020,(7):813~819
超声引导下对撤机失败儿童进行膈肌手法干预的疗效观察    点此下载全文
姚叶林  陈 康  陶金好  陈伟明  秦 妍  王素娟
复旦大学附属儿科医院康复科,上海,201102
基金项目:
DOI:10.3969/j.issn.1001-1242.2020.07.009
摘要点击次数: 129
全文下载次数: 60
摘要:
      摘要 目的:比较常规康复和超声引导下手法干预,对撤机失败儿童的疗效。 方法:初次撤机困难儿童20例(总共89例儿童进行撤机,成功69例),按照随机数字表法分为试验组和观察组各10例,接受30—45min/次,2次/d的康复项目,直至撤机。试验组的项目为超声引导下挑选出的最优项目,观察组的项目为常规套餐。21天为试验终点。疗效评价以再次带机至末次撤机流程前天数?T作为主要指标,以撤机流程前膈肌超声参数作为次要指标。 结果:撤机困难组和成功组,撤机流程前膈肌超声参数移动度、厚度、膈肌增厚分数(DTF)均有显著性差异,其中DTFMIN差异最显著[(13.50±4.98)% vs (18.78±5.74)%,P<0.01]。撤机困难组经过康复干预,试验组与观察组?T有显著性差异[6(5.389—6.611)天vs 10(8.842—11.518)天,P<0.01];各组干预前后膈肌超声参数DTFMIN都有显著性差异(15.52±4.30 vs 17.88±3.12;12.45±4.90 vs 17.68±6.11。均P<0.05)。最终撤机成功组末次撤机流程前与初次撤机成功组初次撤机流程前相比,膈肌超声DTF及其他参数,无显著性差异(P>0.05)。 结论:在超声引导下对撤机失败儿童进行针对性的个体化的膈肌手法干预,可以增强膈肌功能,帮助更早撤机。
关键词:超声  撤机  儿童  膈肌  手法干预
The curative effect of diaphragm manipulation under the guidance of ultrasound on children with failure of weaning    Download Fulltext
Pediatric Hospital Affiliated to Fudan University,Shanghai,201102
Fund Project:
Abstract:
      Abstract Objective:To compare the curative effect of routine rehabilitation and manipulation intervention under the guidance of ultrasound on children with failure of weaning. Method:Totally 89 cases were enrolled in the first weaning process and 69 cases were successful. 20 children who failed firstly were divided into experimental group (n=10) and observation group (n=10) according to the random number table method. Rehabilitation intervention were continuously performed until patients successfully weaned or for a maximum duration of 21 days. The intervention projects in the experimental group were selected under the guidance of ultrasound, while those in the observation group were given routine packages. The evaluation of the curative effect took the number of days from repeated mechanically support to the last weaning process(?T) as the main indicator, and the ultrasonic parameters of the diaphragm before the weaning process as the secondary indicator. Result:There were significant differences in diaphragm functional parameters such as mobility, thickness and DTF between the difficult weaning group and the successful group, and the DTFMIN was the most significantly different [(13.50 ±4.98)% vs (18.78 ±5.74)%, P<0.01]. After rehabilitation intervention, there was a significant difference of ?T between the experimental group and the observation group[6(5.389—6.611)d vs 10(8.842—11.518)d,P<0.01],and the diaphragm functional parameters DTFMIN were significantly different in both groups before and after rehabilitation intervention(15.52±4.30 vs 17.88±3.12; 12.45±4.90 vs 17.68±6.11. All P<0.05). The DTF and other parameters of diaphragm before the last weaning process in children of difficult weaning group were not significantly different from those before first weaning process in children of successful group (P>0.05). Conclusion:Targeted rehabilitation manipulations selected and performed individually on difficult weaning children by ultrasound guidance could enhance the diaphragm function and facilitate weaning earlier than routine rehabilitation packages.
Keywords:ultrasound  weaning  children  diaphragm  manipulation
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