潘伍瑶,
郑金玲,
姜永梅^,
大连医科大学附属第二医院 康复医学科，辽宁 大连 116027

基金项目: 大连医科大学附属第二医院院内基金项目（2022LCJSYS18）


详细信息 作者简介: 潘伍瑶（1998-），女，硕士研究生。E-mail：331189506@qq.com



通讯作者: 姜永梅，教授。E-mail：2514795137@qq.com 中图分类号: R493；R564


摘要:临床中，发生呼吸衰竭的患者通常应用机械通气（MV）来优化体内外气体交换，以补偿因肺损伤和体液过载而导致的呼吸负荷增加。然而，持续的机械通气会引起膈肌无力以及肌纤维萎缩。大量证据表明，MV改变了膈肌的结构和功能，引起膈肌无力，即呼吸机相关性膈肌功能障碍（VIDD），导致一系列严重后果，如脱机困难、恢复延迟、转归不佳、并发症增多、生活质量下降以及死亡风险增加等。本文对VIDD的相关研究进展，特别是VIDD的发生机制与治疗进行综述，旨在为今后VIDD的深入研究及探索VIDD新的治疗方式提供依据。
关键词: 危重症肌病/
呼吸机相关性膈肌功能障碍/
机械通气/
脱机失败


Abstract:Clinically, patients with respiratory failure are usually treated with mechanical ventilation (MV) to optimize air exchange in and out of the body and compensate for the increased respiratory load due to lung injury and fluid overload. However, continuous MV may cause diaphragm weakness and muscular atrophy. There are strong evidence that MV changes diaphragmatic structure and function, causing diaphragmatic weakness and ventilator-induced diaphragmatic dysfunction (VIDD), which leads to a range of serious outcomes, such as difficulty weaning, delayed recovery, poor outcomes, increased complications, reduced quality of life, and increased risk of death. Based on recent advances in the study of VIDD, this paper has summarized the etiology, mechanism, diagnosis, prevention and treatment of the disease, providing a basis for future studies.
Keywords:critical illness myopathy/
ventilator-induced acquired diaphragmatic dysfunction/
mechanical ventilation/
weaning failure

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https://journal.dmu.edu.cn/data/article/export-pdf?id=65090eacfa89b2fe327f3311