RÉSUMÉ
Objective:To investigate the intervention effect of sling exercise therapy on ventilator-induced diaphragm dysfunction (VIDD) in patients with mechanical ventilation, and to provide the reference for prevention and treatment of VIDD.Methods:By a prospective randomized controlled study method, a total of 74 mechanical ventilation patients in Guangzhou Red Cross Hospital from July 2022 to July 2023 were convenient selected, they were divided into the experimental group and the control group according to the random number table method with 37 cases in each group. Both groups were given routine nursing care, the control group carried out early rehabilitation exercise, the experimental group implemented sling exercise therapy. The diaphragm function, respiratory function after the different time of intervention, and outcome events were compared between two groups.Results:Finally, the experimental group included 34 cases, 22 males and 12 females, aged (55.50 ± 12.03) years old. The control group included 36 cases, 25 males and 11 females, aged (54.78 ± 12.81) years old. There was no significant difference in the diaphragm function, respiratory function before intervention(all P>0.05). After 7 d of intervention, the diaphragmatic excursion, diaphragm thickening fraction were (1.59 ± 0.21) cm, (45.90 ± 5.20) % in the experimental group, which were higher than those in the control group (1.49 ± 0.21) cm, (42.78 ± 5.51) %, the differences were statistically significant ( t=2.13, 2.44, both P<0.05). After 5, 7 d of intervention, the rapid shallow breathing index was (81.47 ± 6.97), (77.29 ± 8.91) times. min -1.L -1 in the experimental group, which were lower than those in the control group (88.36 ± 9.04), (84.67 ± 9.64) times.min -1.L -1; after 3, 5, 7 d on intervention, the oxygenation index was (230.79 ± 44.79), (241.59 ± 23.79), (258.56 ± 23.09) mmHg(1 mmHg=0.133 kPa) in the experimental group, which were higher than those in the control group (197.25 ± 21.21), (212.72 ± 21.81), (242.75 ± 24.37) mmHg, the differences were statistically significant ( t values were 2.78-5.30, all P<0.05). The mechanical ventilator time and the length of stay in ICU were (225.29 ± 47.31) h, (12.47 ± 3.71) d in the experimental group, which were lower than those in the control group (260.53 ± 56.32) h, (14.64 ± 4.53) d, the differences were statistically significant ( t=2.83, 2.18, both P<0.05). The incidence rate of VIDD was 5.9%(2/34) in the experimental group, which was lower than that in the control group 22.2%(8/36), and the weaning success rate was 91.2%(31/34) in the experimental group, which was higher than that in the control group 72.2% (26/36), the differences were statistically significant ( χ2=4.18, 4.15, both P<0.05). Conclusions:Sling exercise therapy can effectively promote diaphragm function and respiratory function, shorten mechanical ventilator time and the length of stay in ICU of patients with mechanical ventilation, and reduce the occurrence of VIDD.