Application Of Electroacupuncture Combined With Extracorporeal Diaphragmatic Pacing Therapy Inpatients With Mechanically Ventilated Diaphragm Dysfunction

Objective In this study,electroacupuncture and extracorporeal diaphragm pacing were used as rehabilitation methods to explore the efficacy of electroacupuncture combined with extracorporeal diaphragm pacing in patients with ventilator-associated diaphragmatic dysfunction(VIDD),in order to provide a new way for the rehabilitation of VID in mechanically ventilated patients.Methods Using the randomized controlled study design,94 patients with mechanical ventilation diaphragm dysfunction who were treated in a tertiary hospital in Hangzhou from October 2022 to March 2023 were selected as the research objects,and were divided into two groups according to the random number table method,the control group(extracorporeal diaphragm pacing group)and the observation group(electroacupuncture combined with external diaphragm pacing group),each group of 47 cases.On the basis of routine symptomatic treatment such as sedation and analgesia,anti-infection,fluid rehydration,and nutritional support,the two groups were given extracorporeal diaphragm pacing,electroacupuncture combined with extracorporeal diaphragm pacing,and bedside ultrasound was used to measure the data,and the relevant indicators were monitored on the 1st and 7th days of intervention,weaning and transfer-out.The indicators monitored weas:fractional diaphragm thickening(DTF),diaphragm mobility(DE),weaning results and prognosis:time to start spontaneous breathing test(SBT);duration of mechanical ventilation;Weaning success rate;length of intensive hospital stay;Inpatient fatality rate,and collect,collate,count and analyze relevant data.Results 1.The general data of the two groups of patients included gender,age,acute physiological and chronic health status Ⅱ(APACHEⅡ.)score,hemoglobin,albumin,blood gas analysis(PH,PaO2,PaCO2),and DTF and DE before intervention,and P was>0.05,and the difference was not statistically significant.2.A total of 94 cases were included in this study,and 7 cases died during the implementation of the intervention,including 3 cases in the observation group and 4 cases in the control group.Finally,44 cases in the observation group and 43 cases in the control group were included.The DTF of the two groups at different times was compared within the group,and the DTF on the first day after enrollment,P>0.05,was not statistically significant,and the P was<0.05 on the 7th day,weaning and transfer-out,and the difference was statistically significant.The DTF[(18.09±1.29)VS(34.05±1.29)]VS(34.051.29)]VS control group DTF[(18.12±1.42)VS(32.40±1.45)],P was<0.05 between the two groups,and the difference was also statistically significant.Moreover,DTF gradually increased with the extension of the intervention time,and the increase was greater in the observation group and the efficacy was more significant.For pairwise comparisons of DTF at each time point in the group,P was average<0.05,the difference is also statistically significant.3.The two groups had a<of 0.05 for DE at different times,and the difference was statistically significant.The comparison between the two groups showed that the P was<0.05,and the difference was also statistically significant.4.Compared with the control group,the time of starting spontaneous breathing test and mechanical ventilation time were shortened,and the P was<0.05,and the difference was statistically significant.The length of severe hospital stay was shortened,the withdrawal rate was increased,and the mortality rate was reduced,but the P was>0.05,and the difference was not statistically significant.Conclusion 1.Electroacupuncture combined with in vitro diaphragm pacing can improve the diaphragm thickening fraction and diaphragm mobility in patients with mechanically ventilated diaphragm dysfunction,and improve diaphragm function.2.Electroacupuncture can start the spontaneous breathing test as early as possible and shorten the time of mechanical ventilation.