腹部电刺激联合高频胸壁振荡对气管切开重症患者气道廓清能力的效果

doi:10.3969/j.issn.1006-9771.2022.02.015

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (2): 232-241.doi: 10.3969/j.issn.1006-9771.2022.02.015

腹部电刺激联合高频胸壁振荡对气管切开重症患者气道廓清能力的效果

胡正永¹,马明^2a(),杨玺^2a,殷锦霞^2b,史进军^2c

1.南京体育学院,江苏南京市 210014
2.东南大学附属中大医院,a.康复医学科;b.疼痛科;c.超声医学科,江苏南京市 210009

收稿日期:2021-07-28 修回日期:2021-10-25 出版日期:2022-02-25 发布日期:2022-03-09
通讯作者: 马明 E-mail:NJ9868@163.com
作者简介:胡正永(1990-),男,汉族,江苏南京市人,硕士研究生,中级治疗师,主要研究方向：重症康复。|马明(1980-),男,硕士,副主任治疗师,硕士研究生导师,主要研究方向：运动康复。
基金资助:
江苏省研究生科研与实践创新计划项目(KYCX21_1978)

Effect of abdominal electrical stimulation combined with high-frequency chest wall oscillation on airway clearance ability for critical ill patients with tracheostomy

HU Zhengyong¹,MA Ming^2a(),YANG Xi^2a,YIN Jinxia^2b,SHI Jinjun^2c

1. Nanjing Sport Institute, Nanjing, Jiangsu 210014, China
2. a. Department of Rehabilitation Medicine; b. Department of Pain; c. Department of Ultrasound Medicine, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, China

Received:2021-07-28 Revised:2021-10-25 Published:2022-02-25 Online:2022-03-09
Contact: MA Ming E-mail:NJ9868@163.com
Supported by:
Postgraduate Research & Practice Innovation Program of Jiangsu Province(KYCX21_1978)

摘要/Abstract

摘要：

目的观察腹部电刺激联合高频胸壁振荡对气管切开重症患者气道廓清能力的干预效果。方法选取2021年1月至6月在东南大学附属中大医院重症医学科气管切开重症患者84例,随机分为对照组(n = 28)、试验A组(n = 28)和试验B组(n = 28)。三组均接受常规措施和早期活动,试验A组增加高频胸壁振荡治疗,试验B组联合应用腹部电刺激和高频胸壁振荡治疗,共2周。治疗前后使用非自主咳嗽峰流速(ICPF),临床肺部感染评分(CPIS)、膈肌移动度(DE)、膈肌增厚分数(DTF)和腹部肌肉厚度(Tab)评估疗效。结果试验B组ICPF、CPIS、Tab改善程度优于其他两组(P < 0.05),试验B组DE和DTF改善程度更优,但组间比较无显著性差异(F_DE = 0.514, F_DTF = 1.582, P > 0.05)。试验B组腹直肌、腹内斜肌和腹横肌厚度差值与ICPF差值呈显著正相关(r > 0.415, P < 0.05)。治疗前,所有患者ICPF与CPIS呈显著负相关(r = -0.702, P < 0.001)。干预期间均无不良事件发生。结论腹部电刺激联合高频胸壁振荡可以提高气管切开重症患者的气道廓清能力。

关键词: 气管切开, 腹部电刺激, 高频胸壁振荡, 重症, 气道廓清

Abstract:

Objective To observe the effect of abdominal electrical stimulation combined with high-frequency chest wall oscillation on airway clearance ability in critical ill patients with tracheostomy. Methods From January to June, 2021, a total of 84 critical ill patients with tracheostomy in the department of Critical Care Medicine, Zhongda Hospital, Southeast University, were randomly divided into control group (n = 28),experimental group A (n = 28) and experimental group B (n = 28). All the groups received routine therapy and early activities; while high-frequency chest wall oscillation was added to experimental group A, and abdominal electrical stimulation combined with high-frequency chest wall oscillation were added to experimental group B, for two weeks. Their involuntary cough peak flow (ICPF), Clinical Pulmonary Infection Score (CPIS), diaphragmatic excursion (DE), diaphragmatic thickness fraction (DTF) and thickness of abdominal muscle (Tab) were measured before and after treatment. Results The improvement of CPIS, ICPF and Tab were better in the experimental group B than in the other two groups (P < 0.05). The improvement of DE and DTF were slightly better in experimental group B, however, there was no significant difference among groups (F_DE = 0.514, F_DTF = 1.582, P > 0.05). The thickness d-values of rectus abdominis, musculi obliquus internus abdominis and musculus transversus abdominis were positively correlated with the d-value of ICPF in the exprimental group B (r > 0.415, P < 0.05). ICPF was highly negatively correlated with CPIS before treatment for all the patients (r = -0.702, P < 0.001). No adverse events occurred during the intervention period. Conclusion Abdominal electrical stimulation combined with high-frequency chest wall oscillation could improve airway clearance ability in critical ill patients with tracheostomy.

Key words: tracheostomy, abdominal electrical stimulation, high-frequency chest wall oscillation, critical ill, airway clearance

中图分类号:

R562

胡正永,马明,杨玺,殷锦霞,史进军. 腹部电刺激联合高频胸壁振荡对气管切开重症患者气道廓清能力的效果[J]. 《中国康复理论与实践》, 2022, 28(2): 232-241.

HU Zhengyong,MA Ming,YANG Xi,YIN Jinxia,SHI Jinjun. Effect of abdominal electrical stimulation combined with high-frequency chest wall oscillation on airway clearance ability for critical ill patients with tracheostomy[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 232-241.

图/表 12

表1

表2

表3

表4

表5

表6

表7

表8

表9

表10

表11

表12

参考文献 40

[1]	INOUE S, HATAKEYAMA J, KONDO Y, et al. Post-intensive care syndrome: its pathophysiology, prevention, and future directions[J]. Acute Med Surg, 2019, 6(3): 233-246. doi: 10.1002/ams2.2019.6.issue-3
[2]	VANHOREBEEK I, LATRONICO N, VAN DEN BERGHE G. ICU-acquired weakness[J]. Intensive Care Med, 2020, 46(4): 637-653. doi: 10.1007/s00134-020-05944-4
[3]	GOLIGHER E C, JONKMAN A H, DIANTI J, et al. Clinical strategies for implementing lung and diaphragm-protective ventilation: avoiding insufficient and excessive effort[J]. Intensive Care Med, 2020, 46(12): 2314-2326. doi: 10.1007/s00134-020-06288-9
[4]	KAMDAR B B, SURI R, SUCHYTA M R, et al. Return to work after critical illness: a systematic review and meta-analysis[J]. Thorax, 2020, 75(1): 17-27. doi: 10.1136/thoraxjnl-2019-213803
[5]	VAN AERDE N, MEERSSEMAN P, DEBAVEYE Y, et al. Five-year outcome of respiratory muscle weakness at intensive care unit discharge: secondary analysis of a prospective cohort study[J]. Thorax, 2021, 76(6): 561-567. doi: 10.1136/thoraxjnl-2020-216720
[6]	TAN C Y, CHIU N C, LEE K S, et al. Respiratory tract infections in children with tracheostomy[J]. J Microbiol Immunol Infect, 2020, 53(2): 315-320. doi: 10.1016/j.jmii.2018.07.002
[7]	PAPAZIAN L, KLOMPAS M, LUYT C E. Ventilator-associated pneumonia in adults: a narrative review[J]. Intensive Care Med, 2020, 46(5): 888-906. doi: 10.1007/s00134-020-05980-0
[8]	GOLIGHER E C, DRES M, PATEL B K, et al. Lung- and diaphragm-protective ventilation[J]. Am J Respir Crit Care Med, 2020, 202(7): 950-961. doi: 10.1164/rccm.202003-0655CP
[9]	NTOUMENOPOULOS G, HAMMOND N, WATTS N R, et al. Secretion clearance strategies in Australian and New Zealand Intensive Care Units[J]. Aust Crit Care, 2018, 31(4): 191-196. doi: 10.1016/j.aucc.2017.06.002
[10]	葛慧青, 孙兵, 王波, 等. 重症患者气道廓清技术专家共识[J]. 中华重症医学电子杂志(网络版), 2020, 6(3): 272-282.
	GE H Q, SUN B, WANG B, et al. Expert consensus of airway clearance in critically ill patients[J]. Chin J Crit Care Intensive Care Med, 2020, 6(3): 272-282.
[11]	杨晓龙, 邱卓英, 邱服冰, 等. 基于WHO-FICs的重症患者活动康复:Scoping综述[J]. 中国康复理论与实践, 2021, 27(4): 373-384.
	YANG X L, QIU Z Y, QIU F B, et al. Rehabilitation of mobility for critically ill patients based on World Health Organization Family International Classifications: a scoping review[J]. Chin J Rehabil Theory Pract, 2021, 27(4): 373-384.
[12]	HEGLAND K W, DAVENPORT P W, BRANDIMORE A E, et al. Rehabilitation of swallowing and cough functions following stroke: an expiratory muscle strength training trial[J]. Arch Phys Med Rehabil, 2016, 97(8): 1345-1351. doi: 10.1016/j.apmr.2016.03.027
[13]	REYES A, CASTILLO A, CASTILLO J, et al. The effects of respiratory muscle training on peak cough flow in patients with Parkinson's disease: a randomized controlled study[J]. Clin Rehabil, 2018, 32(10): 1317-1327. doi: 10.1177/0269215518774832
[14]	EMIRZA C, ASLAN G K, KILINC A A, et al. Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: a randomized controlled trial[J]. Pediatr Pulmonol, 2021, 56(5): 939-947. doi: 10.1002/ppul.v56.5
[15]	DALL' ACQUA AM S A, SANTOS L J, LEMOS F A, et al. Use of neuromuscular electrical stimulation to preserve the thickness of abdominal and chest muscles of critically ill patients: a randomized clinical trial[J]. J Rehabil Med, 2017, 49(1): 40-48. doi: 10.2340/16501977-2168
[16]	MCCAUGHEY E J, JONKMAN A H, BOSWELL-RUYS C L, et al. Abdominal functional electrical stimulation to assist ventilator weaning in critical illness: a double-blinded, randomised, sham-controlled pilot study[J]. Crit Care, 2019, 23(1): 261. doi: 10.1186/s13054-019-2544-0
[17]	JONKMAN A H, FRENZEL T, MCCAUGHEY E J, et al. Breath-synchronized electrical stimulation of the expiratory muscles in mechanically ventilated patients: a randomized controlled feasibility study and pooled analysis[J]. Crit Care, 2020, 24(1): 628. doi: 10.1186/s13054-020-03352-0
[18]	THILLE A W, BOISSIER F, MULLER M, et al. Role of ICU-acquired weakness on extubation outcome among patients at high risk of reintubation[J]. Crit Care, 2020, 24(1): 86. doi: 10.1186/s13054-020-2807-9
[19]	CHATWIN M, TOUSSAINT M, GONCALVES M R, et al. Airway clearance techniques in neuromuscular disorders: a state of the art review[J]. Respir Med, 2018, 136: 98-110. doi: 10.1016/j.rmed.2018.01.012
[20]	HODGSON C L, STILLER K, NEEDHAM D M, et al. Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adults[J]. Crit Care, 2014, 18(6): 658. doi: 10.1186/s13054-014-0658-y
[21]	HOFFMAN M, CLERCKX B, JANSSEN K, et al. Early mobilization in clinical practice: the reliability and feasibility of the 'Start To Move' Protocol[J]. [ahead of print]. Physiother Theory Pract, 2020. doi: 10.1080/09593985.2020.1805833. doi: 10.1080/09593985.2020.1805833
[22]	ALMEIDA C M, LOPES A J, GUIMARAES F S. Cough peak flow to predict the extubation outcome: comparison between three cough stimulation methods[J]. Can J Respir Ther, 2020, 56: 58-64. doi: 10.29390/cjrt
[23]	SHI Z H, JONKMAN A, DE VRIES H, et al. Expiratory muscle dysfunction in critically ill patients: towards improved understanding[J]. Intensive Care Med, 2019, 45(8): 1061-1071. doi: 10.1007/s00134-019-05664-4
[24]	MCCAUGHEY E J, BOROTKANICS R J, GOLLEE H, et al. Abdominal functional electrical stimulation to improve respiratory function after spinal cord injury: a systematic review and meta-analysis[J]. Spinal Cord, 2016, 54(9): 628-639. doi: 10.1038/sc.2016.31
[25]	JANG M H, SHIN M J, SHIN Y B. Pulmonary and physical rehabilitation in critically ill patients[J]. Acute Crit Care, 2019, 34(1): 1-13. doi: 10.4266/acc.2019.00444
[26]	WALDAUF P, HRUSKOVA N, BLAHUTOVA B, et al. Functional electrical stimulation-assisted cycle ergometry-based progressive mobility programme for mechanically ventilated patients: randomised controlled trial with 6 months follow-up[J]. Thorax, 2021, 76(7): 664-671. doi: 10.1136/thoraxjnl-2020-215755
[27]	GUTIERREZ-ARIAS R E, ZAPATA-QUIROZ C C, PRENAFETA-PEDEMONTE B O, et al. Effect of neuromuscular electrical stimulation on the duration of mechanical ventilation[J]. Respir Care, 2021, 66(4): 679-685. doi: 10.4187/respcare.08363
[28]	VOLPE M S, GUIMARAES F S, MORAIS C C. Airway clearance techniques for mechanically ventilated patients: insights for optimization[J]. Respir Care, 2020, 65(8): 1174-1188. doi: 10.4187/respcare.07904
[29]	LONGHINI F, BRUNI A, GAROFALO E, et al. Chest physiotherapy improves lung aeration in hypersecretive critically ill patients: a pilot randomized physiological study[J]. Crit Care, 2020, 24(1): 479. doi: 10.1186/s13054-020-03198-6
[30]	GRUNOW J J, GOLL M, CARBON N M, et al. Differential contractile response of critically ill patients to neuromuscular electrical stimulation[J]. Crit Care, 2019, 23(1): 308. doi: 10.1186/s13054-019-2540-4
[31]	ZAYED Y, KHEIRI B, BARBARAWI M, et al. Effects of neuromuscular electrical stimulation in critically ill patients: a systematic review and meta-analysis of randomised controlled trials[J]. Aust Crit Care, 2020, 33(2): 203-210. doi: 10.1016/j.aucc.2019.04.003
[32]	MORRISON L, MILROY S. Oscillating devices for airway clearance in people with cystic fibrosis [J]. Cochrane Database Syst Rev, 2020, 4(4): CD006842.
[33]	李秀萍, 郑湘毅. 背心式高频振动排痰与机械振动排痰对老年肺部感染患者的效果观察[J]. 中国呼吸与危重监护杂志, 2017, 16(3): 241-244.
	LI X P, ZHENG X Y. A comparative study between high-frequency chest wall oscillation expectoration and mechanical vibration expectoration in elderly patients with pulmonary infection[J]. Chin J Respir Crit Care Med, 2017, 16(3): 241-244.
[34]	陈贞, 吴金球, 孙滨海. 高频胸壁振荡在腹部术后老年患者中的应用[J]. 解放军护理杂志, 2017, 34(15): 37-40, 52.
	CHEN Z, WU J Q, SUN B H. Application of high frequency chest wall oscillation on elderly patients underwent abdominal surgery[J]. Nurs J Chin PLA, 2017, 34(15): 37-40, 52.
[35]	VORONA S, SABATINI U, AL-MAQBALI S, et al. Inspiratory muscle rehabilitation in critically ill adults. A systematic review and meta-analysis[J]. Ann Am Thorac Soc, 2018, 15(6): 735-744. doi: 10.1513/AnnalsATS.201712-961OC
[36]	GOLIGHER E C, DRES M, FAN E, et al. Mechanical ventilation-induced diaphragm atrophy strongly impacts clinical outcomes[J]. Am J Respir Crit Care Med, 2018, 197(2): 204-213. doi: 10.1164/rccm.201703-0536OC
[37]	吴雨晨, 丁楠楠, 姜变通, 等. 阈值负荷吸气肌训练对呼吸肌功能影响Meta分析[J]. 中国康复理论与实践, 2019, 25(10): 1150-1161.
	WU Y C, DING N N, JIANG B T, et al. Effect of threshold inspiratory muscle training on respiratory muscle function: a meta-analysis[J]. Chin J Rehabil Theory Pract, 2019, 25(10): 1150-1161.
[38]	杨玉洁, 刘桂英, 李若祎, 等. ICU机械通气患者吸气肌训练的研究进展[J]. 中国护理管理, 2020, 20(9): 1436-1440.
	YNAG Y J, LIU G Y, LI R Y, et al. Research progress of inspiratory muscle training for intensive care patients with mechanical ventilation[J]. Chin Nurs Manag, 2020, 20(9): 1436-1440.
[39]	TUINMAN P R, JONKMAN A H, DRES M, et al. Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients: a narrative review[J]. Intensive Care Med, 2020, 46(4): 594-605. doi: 10.1007/s00134-019-05892-8
[40]	VAN HOLLEBEKE M, GOSSELINK R, LANGER D. Training specificity of inspiratory muscle training methods: a randomized trial[J]. Front Physiol, 2020, 11: 576595. doi: 10.3389/fphys.2020.576595

项目	对照组(n = 28)	试验A组(n = 28)	试验B组(n = 28)	F/χ²值	P值
性别(男/女)/n	19/9	21/7	18/10	0.780	0.677
年龄/岁	53.11±8.53	53.21±11.17	51.18±7.56	0.433	0.650
BMI/kg•m^-2	20.95±2.43	22.29±2.50	22.38±2.50	2.929	0.059
机械通气时间/d	15.5(12,18)	11(8.25,16.5)	15(11.25,18)	4.091	0.129
APACHEII评分	11.5(9,18)	13.5(11,18)	11(10,16)	1.495	0.474
SOFA评分	6.50±1.92	6.64±1.83	7.32±2.33	1.302	0.278
GCS评分^a	6.86±2.07	6.54±2.13	6.89±1.95	0.257	0.774
病因/n
重症肺炎	10	13	14	1.256	0.534
脑出血	5	6	7	0.424	0.809
多发性创伤	6	4	4	0.686	0.710
AECOPD	7	5	3	1.948	0.378
影响呼吸功能因素/n				1.449	0.836
吸烟	7	5	5
支气管扩张	1	0	1
慢性阻塞性肺疾病	7	5	3

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	97.94±23.70	180.73±45.64	82.79(67.81~97.77)	-11.339	< 0.001
试验A组	28	102.59±24.33	192.24±44.76	89.65(77.40~101.90)^b	-15.108	< 0.001
试验B组	28	97.26±18.80	224.45±58.02	127.19(108.36~146.01)^c,d	-13.864	< 0.001
F值		0.469	5.789	9.899
P值		0.627	0.004	< 0.001

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	6.32±1.31	3.46±1.91	-2.86(-3.53~-2.18)	8.706	< 0.001
试验A组	28	6.89±1.17	2.96±1.62	-3.93(-4.57~-3.29)^b	12.569	< 0.001
试验B组	28	7.11±1.10	2.11±1.29	-5(-5.56~-4.44)^c,d	18.371	< 0.001
F值		3.240	4.979	12.323
P值		0.044	0.009	< 0.001

组别	n	治疗前	治疗后	差值	Z值^a	P值^a
对照组	28	2.00(1.25, 2.00)	0(0, 1.00)	-1.00(-2.00, -1.00)	-4.681	< 0.001
试验A组	28	2.00(1.25, 2.00)	0(0, 1.00)	-1.00(-2.00, -1.00)^b	-4.686	< 0.001
试验B组	28	2.00(1.00, 2.00)	0(0, 1.00)	-1.50(-2.00, -1.00)^c,d	-4.512	< 0.001
χ²值		0.122	0.106	0.069
P值		0.941	0.948	0.966

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	1.09±0.13	1.44±0.15	0.35(0.28~0.42)	-10.194	< 0.001
试验A组	28	1.06±0.13	1.44±0.14	0.38(0.30~0.46)^b	-10.188	< 0.001
试验B组	28	1.07±0.13	1.47±0.13	0.40(0.33~0.47)^c,d	-11.699	< 0.001
F值		0.405	0.552	0.514
P值		0.688	0.578	0.600

腹部电刺激联合高频胸壁振荡对气管切开重症患者气道廓清能力的效果

Effect of abdominal electrical stimulation combined with high-frequency chest wall oscillation on airway clearance ability for critical ill patients with tracheostomy

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 12

参考文献 40

相关文章 15

Metrics

本文评价

推荐阅读 0

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	30.60±3.36	36.64±3.33	6.04(4.26~7.82)	-6.970	< 0.001
试验A组	28	29.54±3.27	37.56±4.10	8.02(5.90~10.14)^b	-7.761	< 0.001
试验B组	28	30.78±3.15	38.90±4.07	8.13(6.30~9.95)^c,d	-9.140	< 0.001
F值		1.175	2.452	1.582
P值		0.314	0.092	0.212

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	0.54±0.11	0.59±0.12	0.05(0.04~0.07)	-6.735	< 0.001
试验A组	28	0.52±0.12	0.59±0.14	0.07(0.05~0.08)^b	-8.145	< 0.001
试验B组	28	0.49±0.12	0.59±0.13	0.11(0.09~0.12)^c,d	-12.412	< 0.001
F值		1.317	0.017	10.273
P值		0.274	0.983	< 0.001

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	0.38±0.07	0.40±0.07	0.02(0.01~0.03)	-3.000	0.006
试验A组	28	0.36±0.06	0.39±0.06	0.03(0.02~0.03)^b	-12.540	< 0.001
试验B组	28	0.35±0.06	0.39±0.06	0.04(0.03~0.05)^c,d	-9.441	< 0.001
F值		2.089	0.249	7.855
P值		0.130	0.780	0.001

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	0.48±0.11	0.49±0.12	0.01(0~0.03)	-1.872	0.072
试验A组	28	0.47±0.12	0.49±0.12	0.03(0.01~0.04)^b	-4.455	< 0.001
试验B组	28	0.45±0.11	0.50±0.12	0.06(0.04~0.07)^c,d	-8.865	< 0.001
F值		0.601	0.041	10.676
P值		0.551	0.960	< 0.001

组别	n	治疗前	治疗后	差值(95%CI)	t值^a	P值^a
对照组	28	0.23±0.04	0.26±0.04	0.03(0.03~0.04)	-13.899	< 0.001
试验A组	28	0.22±0.05	0.27±0.04	0.04(0.03~0.05)^b	-9.266	< 0.001
试验B组	28	0.22±0.04	0.28±0.04	0.06(0.06~0.07)^c,d	-19.065	< 0.001
F值		0.672	0.929	16.028
P值		0.513	0.399	< 0.001

项目	r	P值
腹直肌	0.495	0.007
腹内斜肌	0.415	0.028
腹外斜肌	0.139	0.481
腹横肌	0.597	0.001

项目	B	OR(95%CI)	P值
BMI	0.320	1.378(0.899~2.111)	0.141
APACHE II	-0.085	0.918(0.611~1.381)	0.683
SOFA	-0.140	0.869(0.557~1.355)	0.535
机械通气天数	-0.151	0.860(0.593~1.246)	0.424

[1]	毛晶,唐晓晓,郑瑶,张金牛,阚秀丽,吴建贤. 重症机械通气患者早期个体化康复的效果[J]. 《中国康复理论与实践》, 2022, 28(6): 710-715.
[2]	葛章伟,黄馨,刘正东,张敏,张家奎. 重症监护室中老年患者术后谵妄影响因素分析及风险预测模型建立与评价[J]. 《中国康复理论与实践》, 2022, 28(3): 340-345.
[3]	杨晓龙,邱卓英,邱服冰,曹磊,张甜甜,宋为群. 基于WHO-FICs的重症患者活动康复：Scoping综述[J]. 《中国康复理论与实践》, 2021, 27(4): 373-384.
[4]	谭金泽,张鸣生,曾凡令,曾斌,邱卓英. 基于国际健康分类架构构建新型冠状病毒病重症病区配对康复治疗模式及其效果[J]. 《中国康复理论与实践》, 2021, 27(4): 385-393.
[5]	周惠嫦,张盘德,卫小梅,窦祖林. 应用气管单向阀对脑出血气管切开术后吞咽障碍患者误吸的疗效[J]. 《中国康复理论与实践》, 2020, 26(11): 1292-1296.
[6]	潘世琴, 王丽, 王玉宇. 危重症患者肌力评定方法的研究进展[J]. 《中国康复理论与实践》, 2019, 25(9): 1052-1056.
[7]	夏嘉川, 罗忠纯, 郭祥奎, 邓强, 杨雪, 叶茜. 气管切开后拔管策略对拔管成功率的影响[J]. 《中国康复理论与实践》, 2018, 24(9): 1067-1071.
[8]	马志明, 苏洁, 孙晖, 何莎, 苏国栋. 个性化康复护理结合音乐治疗对重症肺炎并发多脏器功能衰竭效果1例报道[J]. 《中国康复理论与实践》, 2018, 24(4): 488-491.
[9]	杨玲, 王国防, 丁意平, 刁珊珊, 徐耑. 重症肌无力伴胸腺瘤或胸腺增生的临床特征及预后[J]. 《中国康复理论与实践》, 2017, 23(12): 1425-1430.
[10]	潘世琴, 张情, 王丽. 早期活动防治重症监护室获得性衰弱的研究进展[J]. 《中国康复理论与实践》, 2017, 23(1): 50-53.
[11]	张瑜，姚秋近，张一，王卉，严程，王涯，吴野环，朱婧，杨伊林. 中文版约翰霍普金斯改良认知评价量表在神经系统重症监护室患者认知功能测评中的效度①[J]. 《中国康复理论与实践》, 2016, 22(5): 514-517.
[12]	吴野环;张一;姚秋近;陈超;王涯;张瑜. 重症监护病房患者认知功能评定工具的研究进展[J]. 《中国康复理论与实践》, 2015, 21(11): 1287-1289.
[13]	谢纯青;温红梅;万桂芳;武惠香;窦祖林. 说话瓣膜配合综合性吞咽康复在气管切开后患儿中的应用1例报道[J]. 《中国康复理论与实践》, 2015, 21(11): 1315-1318.
[14]	王万玲;袁凌;谭静;帅霞. 综合康复对下肢危重烧伤老年患者膝关节功能的效果[J]. 《中国康复理论与实践》, 2015, 21(01): 117-119.
[15]	王锁彬;贾建平. 成人甲状腺功能减退性肌病的临床表现[J]. 《中国康复理论与实践》, 2009, 15(01): 19-21.