高级检索

血流限制训练在ICU患者中的应用效果观察

Effect of blood flow restriction training in ICU patients

    摘要
  • 摘要:
      背景  血流限制训练(blood flow restriction training，BFRT)是一种高效的骨骼肌康复训练方法，可以有效增强患者的肌肉力量和质量。
      目的  探讨下肢血流限制训练维持或增强ICU患者肌肉力量和质量的有效性。
      方法  选取2021年1月- 2022年1月北京市某三甲医院重症医学科收治的患者45例，按计算机随机法将患者分为60%肢体闭塞压(limb occlusion pressure，LOP)组、40%LOP组和对照组，每组15例。三组患者均接受ICU常规治疗护理，对照组单纯下肢活动，实验组捆绑血流限制袖带活动下肢。干预前后记录患者的医学研究理事会评分(Medical Research Council score，MRC-Score)，干预前、干预第3天、干预第5天、干预第7天、干预后对患者的股直肌横截面积(rectus femoris cross-sectional area，RF-CSA)、股直肌肌肉厚度(rectus femoris muscle thickness，RF-MT)、腓肠肌内侧头横截面积(medial gastrocnemius cross-sectional area，MG-CSA)、腓肠肌内侧头肌肉厚度(medial gastrocnemius muscle thickness，MG-MT)进行测量并记录。
      结果  三组患者年龄、性别等基线资料差异无统计学意义(P＞0.05)。三组患者干预前后的MRC-Score差异无统计学意义(P＞0.05)。60%LOP组干预后MRC-Score较干预前显著增加(P＜0.05)。对照组RF-CSA、MG-CSA、MG-MT在干预中各时间点与干预前相比均减少(P＜0.05)，60%LOP组各时间点肌肉参数无明显变化(P＞0.05)，40%LOP组MG-CSA、MG-MT部分时间点与干预前相比减少(P＜0.05)。三组MG-CSA差值均增加，实验组MG-CSA差值小于对照组(P＜0.05)，60%LOP较40%LOP组更小。对照组MG-MT干预前后差值大于60%LOP组(P＜0.05)，与40%LOP组相比差异无统计学意义(P＞0.05)。
      结论  ICU患者进行40%LOP和60%LOP的下肢BFRT可以延缓肌肉萎缩，其中60%LOP相比40%LOP作用更显著。

     

    Abstract:
      Background   Blood flow restriction training (BFRT) is an efficient skeletal muscle rehabilitation training method, which can effectively enhance the muscle strength and quality of patients.
      Objective   To investigate the effectiveness of lower limb blood flow restriction training in maintaining or enhancing muscle strength and mass in ICU patients.
      Methods   From January 2021 to January 2022, 45 patients admitted to the ICU of a grade A hospital in Beijing were selected. Patients were randomly divided into 60% limb occlusion pressure (LOP) group, 40% LOP group and control group, with 15 cases in each group. Patients in the three groups received ICU routine treatment and nursing measures, the control group had no blood flow restriction to move the lower limbs, patients in the 60% LOP group and 40% LOP group were trained with blood flow restriction cuff in the lower limbs. Medical Research Council Score (MRC-Score) was evaluated before and after intervention. Rectus femoris cross-sectional area (RF-CSA), rectus femoris muscle thickness (RF-MT), medial gastrocnemius cross-sectional area (MG-CSA), and medial gastrocnemius muscle thickness (MG-MT) before and on day 3, 5, 7 after intervention were measured and recorded.
      Results   There were no significant differences in age, gender and other general information among the three groups (P＞0.05), and no significant difference was found in MRC-score before and after intervention among the three groups (P＞0.05). The MRC-score of 60% LOP group increased significantly after intervention compared with before intervention (P＜0.05). In the control group, RF-CSA, MG-CSA and MG-MT decreased at each time point during the intervention compared with before intervention (all P＜0.05), while the muscle parameters of 60% LOP group did not change significantly at each time point (P＞0.05). MG-CSA and MG-MT in 40% LOP group decreased significantly compared with before intervention (all P＜0.05). The difference of MG-CSA in the experimental group was smaller than that in the control group (P＜0.05), and the difference of MG-CSA in 60% LOP group was smaller than that in 40%LOP group. The difference between the control group and the 40% LOP group before and after MG-MT intervention was greater than that of the 60%LOP group (all P＜0.05), but there was no significant difference between the control group and the 40% LOP group (P＞0.05).
      Conclusion  Lower limb BFRT with 40% LOP and 60% LOP can alleviate muscle atrophy in ICU patients. 60% LOP is more effective than 40% LOP.

     

    • HTML全文
    • 参考文献(32)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回
下载中心
    友情链接