电针刺激迷走神经对神经外科术后合并呼吸机相关肺炎患者的临床观察

发布时间：2018-03-21 11:03

  本文选题：呼吸机相关肺炎　切入点：迷走神经刺激术　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察运用电针刺激迷走神经对神经外科术后呼吸机相关肺炎(VAP)患者的临床疗效。方法:采用前瞻性单盲随机对照研究方法,选取2016年4月至7月新疆医科大学第一附属医院重症医学科收治的45例神经外科术后合并呼吸机相关肺炎患者为研究对象。按随机数字表编码法将患者分为常规组(n=23)和电针组(n=22),常规组根据中华医学会制定的2013年《呼吸机相关性肺炎诊断、预防和治疗指南(2013)》,给予抗菌药物治疗、支持治疗及物理治疗等。电针组在对照组的基础上,电针刺激下肢迷走神经每日两次,每次30min。两组均连续治疗7d。记录两组患者治疗前和治疗后3、7d的急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,记录两组患者治疗前和治疗后3、7 d日的WBC、PCT、IL-6、CRP等。结果:与常规组对比,电针组在3d、7d的APACHEⅡ评分明显降低并且有统计学差异。炎症因子方面,与常规组对比,电针组在7d的PCT、IL-6、WBC较常规组下降更加显著(P0.05),而在0d、3d,PCT、IL-6、WBC等炎症因子无明显差异(P0.05)。而CRP在所有时间段两组均无明显差异(P0.05)。结论:运用电针连续刺激VAP患者迷走神经,可明显改善患者临床表现,降低炎症因子水平,从而缩短病程,有利于患者术后恢复。电针刺激可作为重要补充方法运用在VAP综合治疗中。
[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，

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