膈肌电刺激对重症脑卒中机械通气患者撤机成功率的影响OA

Objective To analyze the effect of diaphragmatic electrical stimulation(DES)on weaning success rate and complications among critically ill stroke patients undergoing mechanical ventilation.Methods A retrospective study was conducted on 100 critically ill stroke patients undergoing mechanical ventilation admitted to Shanghai Changzheng Hospital from October 2022 to October 2024.Patients receiving conventional treatment were included in the control group(47 patients),and those receiving DES in addition to conventional treatment were included in the study group(53 patients).Outcomes were compared between the two groups,including prognosis indicators(duration of mechanical ventilation,length of ICU stay,weaning success rate,and reintubation within 48 hours),diaphragmatic function,respiratory efficiency,oxygenation index,arterial oxygen partial pressure,and complications.Results The duration of mechanical ventilation and length of ICU stay in the control group were(7.23±1.22)days and(13.24±2.43)days,respectively,while those in the study group were(6.62±1.15)days and(12.21±1.93)days,respectively,which were significantly shorter than those in the control group(P<0.05).The weaning success rate in the study group was 84.91%,which was significantly higher than 65.96%in the control group.The reintubation rate within 48 hours in the study group was 5.66%,which was significantly lower than 19.15%in the control group(P<0.05).No significant difference was observed in diaphragmatic thickness variability between the two groups on the third day of treatment(P>0.05).On the seventh day and fourteenth day of treatment,diaphragmatic thickness variability increased significantly in both groups,the study group had higher values than the control group(P<0.05).The rapid shallow breathing index in the study group was significantly lower,while the maximum expiratory pressure and maximum inspiratory pressure were significantly higher compared to the control group(P<0.05).On the third day of treatment,there were no significant differences in oxygenation index and arterial oxygen partial pressure between the two groups(P>0.05).However,on the seventh day and fourteenth day of treatment,both parameters increased significantly in both groups,the study group had higher values than the control group(P<0.05).The complication rate in the control group was 23.41%,which was 15.09%in the study group,with no significant difference(P>0.05).Conclusion DES can effectively improve diaphragmatic function and respiratory efficiency among critically ill stroke patients undergoing mechanical ventilation,thereby enhancing weaning success rate and reducing complications,demonstrating highly secure.