Chest:高平面脊髓损伤患者全身混合划船过程中急性通气支持的疗效

2019-11-16 xing.T MedSci原创

由此可见,急性NIV可以成功改善SCI患者进行FES划船运动期间的通气效率,但可能不能改善所有患者的VO2峰值。受益最多的人似乎是受伤时间较短的颈部SCI患者。

高平面脊髓损伤(SCI)会导致严重的脊髓和脊柱上神经功能缺损,从而导致全身混合功能性电刺激(FES)划船运动过程中出现严重的通气受限,这种运动形式通过电刺激诱导的腿部收缩显著增加了活动肌肉的质量。近日,呼吸领域权威杂志chest上发表了一篇研究文章,研究旨在评估SCI期间无创通气(NIV)对通气和有氧运动能力的影响。

研究人员对19名SCI(C4-T8)患者进行了一项盲法随机交叉研究。所有患者都熟悉FES划船运动,并且与训练有关的有氧运动能力增加达到平稳状态。患者使用NIV或Sham进行了2次FES划船峰值运动测试。

与Sham组相比,NIV增加了运动潮气量(峰值:1.50±0.31 vs. 1.36±0.34 L,p<0.05)和呼吸频率降低(峰值:35±7 vs. 38±6 bpm,p<0.05),导致肺泡通气(VA)不变,但有增加氧气吸收效率的趋势(p=0.06)。在达到VO2峰值标准的患者(n=13)中,NIV无法显著增加VO2峰值(1.73±0.66 vs. 1.78±0.59 L/min);然而,反应范围揭示了VA峰值和VO2峰值变化之间的相关性(r=0.89,p<0.05)。此外,那些受伤程度较高,受伤后时间较短的患者VO2峰值增幅最大。

由此可见,急性NIV可以成功改善SCI患者进行FES划船运动期间的通气效率,但可能不能改善所有患者的VO2峰值。受益最多的人似乎是受伤时间较短的颈部SCI患者。 

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    2020-03-24 Smile2680
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    2019-11-16 内科新手

    谢谢梅斯提供这么好的信息,学到很多

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