呼吸肌训练对亚急性期脑卒中患者呼吸功能的影响

被引：52

作者：

俞长君

李雪萍

林强

程凯

蔡雨星

张会慧

赵秋云

夏鹏

机构：

[1] 南京,南京医科大学附属南京医院(南京市第一医院)康复医学科

来源：

中华物理医学与康复杂志 | 2016年 / 38卷 / 10期

关键词：

脑卒中; 呼吸肌; 呼吸功能; 肺通气;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）]; R493 [医学康复（康复疗法）];

学科分类号：

100204 [神经病学]; 100232 [康复医学];

摘要：

目的探讨呼吸肌训练对亚急性期脑卒中患者呼吸功能的影响。方法选取50例首次发病亚急性期脑卒中患者, 按随机数字表法分为对照组和观察组, 每组25例。由于患者失去康复治疗的积极性、出院等原因, 有5例患者退出(其中对照组2例, 观察组3例), 最终有45例患者完成本研究。2组患者均根据自身功能障碍情况给予相应的常规康复功能治疗, 观察组在此基础上增加呼吸肌训练。每日2次, 每周6 d, 康复治疗共3周。分别于治疗前和治疗3周后(治疗后), 对2组患者进行血气分析、肺通气功能测定和呼吸肌肌力测定, 并采用Fugl-Meyer运动功能评定量表(FMA)上肢及下肢部分对2组患者的上下肢运动功能进行评定, 采用Barthel指数(BI)对2组患者的日常生活活动(ADL)能力进行评分;然后随访观察3个月, 分析和比较2组患者肺部感染和再发脑卒中的发生率。结果治疗后, 2组患者动脉氧分压(PaO2)、用力肺活量(FCV)、一秒用力呼气容积(FEV1)、每分钟最大通气量占预计值的百分比(MVV%)、峰值呼气流速(PEF)、最大静止吸气压(PImax)、最大静止呼气压(PEmax)、上肢及下肢Fugl-Meyer运动功能评分、Barthel指数评分均较组内治疗前有明显提高, 且差异有统计学意义(P<0.05);且治疗后除FMA和BI评分外, 观察组其余各项指标均高于对照组, 组间差异有统计学意义(P<0.05)。随访3个月发现, 2组患者肺部感染率组间比较, 观察组低于对照组, 差异亦有统计学意义(P<0.05);而2组患者再发脑卒中的发生率组间比较, 差异无统计学意义(P>0.05)。结论亚急性期脑卒中患者通过呼吸肌训练能有效增加呼吸肌肌力, 提高动脉氧分压, 改善肺通气功能, 降低肺部感染率。

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