發(fā)布時間：2018-03-21 11:03

  本文選題：呼吸機相關肺炎　切入點：迷走神經刺激術　出處：《新疆醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:觀察運用電針刺激迷走神經對神經外科術后呼吸機相關肺炎(VAP)患者的臨床療效。方法:采用前瞻性單盲隨機對照研究方法,選取2016年4月至7月新疆醫(yī)科大學第一附屬醫(yī)院重癥醫(yī)學科收治的45例神經外科術后合并呼吸機相關肺炎患者為研究對象。按隨機數(shù)字表編碼法將患者分為常規(guī)組(n=23)和電針組(n=22),常規(guī)組根據中華醫(yī)學會制定的2013年《呼吸機相關性肺炎診斷、預防和治療指南(2013)》,給予抗菌藥物治療、支持治療及物理治療等。電針組在對照組的基礎上,電針刺激下肢迷走神經每日兩次,每次30min。兩組均連續(xù)治療7d。記錄兩組患者治療前和治療后3、7d的急性生理學與慢性健康狀況評分系統(tǒng)Ⅱ(APACHEⅡ)評分,記錄兩組患者治療前和治療后3、7 d日的WBC、PCT、IL-6、CRP等。結果:與常規(guī)組對比,電針組在3d、7d的APACHEⅡ評分明顯降低并且有統(tǒng)計學差異。炎癥因子方面,與常規(guī)組對比,電針組在7d的PCT、IL-6、WBC較常規(guī)組下降更加顯著(P0.05),而在0d、3d,PCT、IL-6、WBC等炎癥因子無明顯差異(P0.05)。而CRP在所有時間段兩組均無明顯差異(P0.05)。結論:運用電針連續(xù)刺激VAP患者迷走神經,可明顯改善患者臨床表現(xiàn),降低炎癥因子水平,從而縮短病程,有利于患者術后恢復。電針刺激可作為重要補充方法運用在VAP綜合治療中。
[Abstract]:Objective: to observe the clinical effect of vagus nerve stimulation on patients with ventilator associated pneumonia (VAP) after neurosurgery. From April 2016 to July, 45 patients with ventilator-associated pneumonia in the Department of intensive Medicine, the first affiliated Hospital of Xinjiang Medical University, were selected as study subjects. The routine group was diagnosed with ventilator-associated pneumonia according to the 2013 of the Chinese Medical Association. Prevention and treatment guidelines (2013) >, Antimicrobial Therapy, support Therapy, physical Therapy, etc. The electroacupuncture group, on the basis of the control group, stimulates the vagus nerve of the lower extremity twice a day. 30 mins each time, both groups were treated continuously for 7 days. The acute physiology and chronic health status scoring system 鈪，

本文編號：1643563