Intensīvā terapija un mākslīgā plaušu ventilācija pacientiem ar Covid-19 infekciju (literatūras apskats)
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Date
2021
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Mūsdienās izplatītas ir profesijas, kuras saistītas ar ilgstošu stāvēšanu, piemēram, frizieri, ķirurgi un operāciju māsas, dažādu veikalu darbinieki. Ilgstoša stāvus pozīcija tiek asociēta ar dažādām nopietnām veselības problēmām, kā muguras lejas daļas un apakšēju ekstremitāšu sāpēm un tūsku, sirds un asinsvadu sistēmas problēmām, nogurumu, diskomfortu un grūtniecības komplikācijām. Tiek izmantotas dažādas intervences, lai mazinātu veselības problēmas šiem darbiniekiem. Efektīvas intervences ir ergonomiskie pretnoguruma paklāji, kas mazina muskuļu sāpes, tūsku un nogurumu. Paklāji rada mīkstu un nestabilu virsmu, kas provocē mikrokustības, tādējādi tiek radīta fāziska muskuļu aktivitāte, kas stimulē pasīvā orgāna - vēnu darbību, kas rezultējas ar uzlabotu venozo atteci. Papildus paklāji un zoles mīkstina stāvēšanas virsmu. Tas palīdz vienmērīgāk sadalīt svara izraisīto slodzi un mazināt audu kompresiju, līdz ar to arī skrimšļu deģenerāciju un Reimatisko slimību attīstības risku [1,2]. Darba mērķis. Salīdzināt, kādas ir apakšstilbu (m.gastrocnemius) un muguras jostas daļas (m.erector spinae) mikrokustību atšķirības stāvot uz pretnoguruma paklāja un grīdas, velkot apavus ar plakanu zoli un apavus ar 3cm augstu papēdi. Materiāli un metodes. 10 jauniem un veseliem dalībniekiem tika veikti virsmas elektromiogrāfijas pieraksti abām m.gastrocnemius galvām un m.erecotor spinae longissimus bilaterāli. Tika analizēti parametri dalībniekiem stāvot apavos ar plakanu zoli un apavos ar 3cm augstu papēdi, uz grīdas un uz pretnoguruma paklāja. Rezultāti. Statistiski nozīmīgu atšķirību, stāvot uz pretnoguruma paklāju pret stāvēšanu uz grīdas, vēro visos analizētajos muskuļos gan velkot apavus ar plakanu zoli, gan 3cm augstu papēdi. MESD (m.erector spinae dextra) mediāna stāvot apavos ar plakanu zoli uz grīdas ir 8,38μV, bet uz paklāja 9,52μV (p=0,007). MESD mediāna stāvot apavos ar 3cm augstu zoli ir 7,82μV, bet uz paklāja 10,86μV (p=0,005). MESS (m.erector spinae sinistra) mediāna stāvot apavos ar plakanu zoli uz grīdas ir 7,25μV, bet uz paklāja 8,61μV (p=0,013). MESS mediāna stāvot apavos ar 3cm augstu zoli uz grīdas ir 8,89 μV, bet uz paklāja ir 10,49 μV. MGLD (m.gastrocnemius lateralis dextra) mediāna stāvot apavos ar plakanu zoli uz grīdas ir 19.20μV, bet uz paklāja 37.13μV (p=0,005). MGLD mediāna stāvot apavos ar 3cm augstu zoli ir 26,37μV , bet uz paklāja 32,19μV (p=0,005). MGLS (m.gastrocnemius lateralis sinistra) mediāna stāvot apavos ar plakanu zoli uz grīdas ir 14,57μV, bet uz paklāja 22,68μV (p=0,009). MGLS mediāna stāvot apavos ar 3cm augstu zoli ir 16,91μV, bet uz paklāja 21,22μV (p=0,005). MGMD (m.gastrocnemius medialis dextra) mediāna stāvot apavos ar 3cm augstu zoli ir 20.38μV, bet uz paklāja 21,82μV (p=0,005). MGMS (m.gastrocnemius medialis sinistra) mediāna stāvot apavos ar 3cm augstu zoli ir 16,82μV, bet uz paklāja 25,53μV (p=0,009). Secinājumi. Kāju muskulatūra, kā arī apavi ar 3cm papēžiem uz pretnoguruma paklāja rada
Introduction. These days, professions involving longterm standing, such as hair-dressers, surgeons and surgical nurses, cashiers, are common. Prolonged standing are associated with a variety of serious health problems, such as pain and swelling of the lower back and lower limbs, cardiovascular problems, fatigue, discomfort and pregnancy complications. Various interventions are being used to reduce health problems for these workers. Effective interventions are ergonomic antifatigue mats that reduce muscle pain, swelling and fatigue. Mat creates a soft and unstable surface that provokes micro-movements, thus creating a phasic muscle activity that stimulates passive organ – vein function that results with enhanced venous reflux. In addition mats and soles soften the standing surface. This helps to spread weight load more evenly and reduce tissue compression, thereby also reducing cartilage degeneration and the risk of developing musculosketeal Diseases [1,2]. Objectives. Compare the differences between the micromovements of the lower limb (m.gastrocnemius) and the lower back (m.erector spinae) while standing on the anti -fatigue mat and the floor, while wearing shoes with flat sole and shoes with a 3 cm heel. Materials and methods. 10 young and healthy participants underwent surface electromyography records for both m.gastrocnemius heads and m.erecotor spinae longissimus bilateraly. The parameters were analyzed for participants standing in flat soled shoes and shoes with a 3 cm high heel, on the floor and on an anti-fatigue mat. Results. Statistically significant difference between standing on the anti-fatigue mat and standing on the floor is found in all analyzed muscles, both with flat-sole shoes and shoes with 3 cm high heel. The median of MESD (m.erector spinae dextra) while standing in shoes with flat sole on the floor is 8,38 μV and on the mate - 9,52 μV (p = 0.007). The median of MESD while standing in shoes with a 3 cm high heel on the floor is 7,82 μV and on the mat - 10,86 μV (p = 0,005). The median of MESS (m.erector spinae sinistra) standing in shoes with flat sole on the floor is 7.25 μV and on the mat - 8,61 μV (p = 0.013). The median of MESS standing in shoes with a 3 cm-high heel on the floor is 8,89 μV, on the mat - 10,49 μV, The median of MGLD (m.gastrocnemius lateralis dextra) standing in shoes with flat sole on the floor is 19.20 μV, on the mat - 37.13 μV (p = 0,005). The median of MGLD standing in shoes with a 3 cm high heel is 26,37 μV and on a mat - 32,19 μV (p = 0,005). MGLS (m.gastrocnemius lateralis sinistra) median standing in shoes with flat sole on the floor is 14,57 μV, on the mat - 22,68 μV (p = 0.009). The median of MGLS standing in shoes with a 3cm high heel is 16,91 μV, on the mat – 21,22 μV (p=0,005). The median of MGMD (m.gastrocnemius medialis dextra) standing in shoes with a 3 cm high heel is 20.38 μV, on the mat - 21,82 μV (p = 0,005). MGMS (m.gastrocnemius medialis sinistra) median standing in s
Introduction. These days, professions involving longterm standing, such as hair-dressers, surgeons and surgical nurses, cashiers, are common. Prolonged standing are associated with a variety of serious health problems, such as pain and swelling of the lower back and lower limbs, cardiovascular problems, fatigue, discomfort and pregnancy complications. Various interventions are being used to reduce health problems for these workers. Effective interventions are ergonomic antifatigue mats that reduce muscle pain, swelling and fatigue. Mat creates a soft and unstable surface that provokes micro-movements, thus creating a phasic muscle activity that stimulates passive organ – vein function that results with enhanced venous reflux. In addition mats and soles soften the standing surface. This helps to spread weight load more evenly and reduce tissue compression, thereby also reducing cartilage degeneration and the risk of developing musculosketeal Diseases [1,2]. Objectives. Compare the differences between the micromovements of the lower limb (m.gastrocnemius) and the lower back (m.erector spinae) while standing on the anti -fatigue mat and the floor, while wearing shoes with flat sole and shoes with a 3 cm heel. Materials and methods. 10 young and healthy participants underwent surface electromyography records for both m.gastrocnemius heads and m.erecotor spinae longissimus bilateraly. The parameters were analyzed for participants standing in flat soled shoes and shoes with a 3 cm high heel, on the floor and on an anti-fatigue mat. Results. Statistically significant difference between standing on the anti-fatigue mat and standing on the floor is found in all analyzed muscles, both with flat-sole shoes and shoes with 3 cm high heel. The median of MESD (m.erector spinae dextra) while standing in shoes with flat sole on the floor is 8,38 μV and on the mate - 9,52 μV (p = 0.007). The median of MESD while standing in shoes with a 3 cm high heel on the floor is 7,82 μV and on the mat - 10,86 μV (p = 0,005). The median of MESS (m.erector spinae sinistra) standing in shoes with flat sole on the floor is 7.25 μV and on the mat - 8,61 μV (p = 0.013). The median of MESS standing in shoes with a 3 cm-high heel on the floor is 8,89 μV, on the mat - 10,49 μV, The median of MGLD (m.gastrocnemius lateralis dextra) standing in shoes with flat sole on the floor is 19.20 μV, on the mat - 37.13 μV (p = 0,005). The median of MGLD standing in shoes with a 3 cm high heel is 26,37 μV and on a mat - 32,19 μV (p = 0,005). MGLS (m.gastrocnemius lateralis sinistra) median standing in shoes with flat sole on the floor is 14,57 μV, on the mat - 22,68 μV (p = 0.009). The median of MGLS standing in shoes with a 3cm high heel is 16,91 μV, on the mat – 21,22 μV (p=0,005). The median of MGMD (m.gastrocnemius medialis dextra) standing in shoes with a 3 cm high heel is 20.38 μV, on the mat - 21,82 μV (p = 0,005). MGMS (m.gastrocnemius medialis sinistra) median standing in s
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
pretnoguruma paklājs, ergonimka, muskuļu saspringums, mikrokustības, nogurums, stāvēšana, Anti-fatigue mat, ergonomy, muscle tension, micromovements, fatigue, standing