呼吸肌训练对脑卒中患者呼吸功能的影响
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摘要
目的评价呼吸肌训练对脑卒中患者呼吸功能的影响。方法回顾性分析2013年9月至2017年9月在郑州市第一人民医院住院治疗的80例脑卒中患者的临床资料,接受常规康复治疗的40例脑卒中患者为对照组,接受常规康复治疗联合呼吸肌训练的40例脑卒中患者为观察组。比较治疗2周前后两组患者的用力肺活量(FVC)、第1秒用力呼气量(FEV1)、1秒率(FEV1%)、每分钟最大通气量(MVV)、肺部感染率,观察治疗3个月后两组患者的脑卒中再发率。结果治疗2周后,两组患者FVC、FEV1、FEV1%、MVV大于治疗前,观察组FVC、FEV1、FEV1%、MVV大于对照组,差异有统计学意义(P <0. 05)。治疗后,两组患者肺部感染率低于治疗前,观察组肺部感染率低于对照组,差异有统计学意义(P <0. 05)。两组患者再次脑卒中发生率比较,差异无统计学意义(P> 0. 05)。结论呼吸肌训练能促进脑卒中患者呼吸功能的恢复,减少肺部感染。
Objective To evaluate the effect of ventilatory muscle training on respiratory function rehabilitation in patients with stroke. Methods The clinical data of 80 patients with stroke hospitalized in the First People's Hospital of Zhengzhou from September 2013 to September 2017 were retrospectively analyzed. Among them,40 patients who received routine rehabilitation therapy were control group,while the other 40 patients who received routine rehabilitation therapy combined with ventilatory muscle training were observation group. The forced vital capacity( FVC),forced expiratory volume( FEV1),one second rate(FEV1%),maximum ventilation volume per minute( MVV) and the incidence of pulmonary infection were compared respectively between the two groups before and after 2 weeks of treatment. The recurrence rates of stroke in two groups were observed after3 months. Results After 2 weeks of treatment,FVC,FEV1,FEV1% and MVV of the two groups were higher than those before the treatment,while the FVC,FEV1,FEV1% and MVV of the observation group were higher than those of the control group(P < 0. 05). After 2 weeks of treatment,the rate of pulmonary infection in the two groups was respective lower than that before the treatment,and the rate of pulmonary infection of the observation group was lower than that of the control group( P < 0. 05).There was no significant difference in the incidence of recurrent stroke between the two groups( P > 0. 05). Conclusion Respiratory muscle training could promote respiratory function recovery and reduce pulmonary infection in stroke patients.
Objective To evaluate the effect of ventilatory muscle training on respiratory function rehabilitation in patients with stroke. Methods The clinical data of 80 patients with stroke hospitalized in the First People's Hospital of Zhengzhou from September 2013 to September 2017 were retrospectively analyzed. Among them,40 patients who received routine rehabilitation therapy were control group,while the other 40 patients who received routine rehabilitation therapy combined with ventilatory muscle training were observation group. The forced vital capacity( FVC),forced expiratory volume( FEV1),one second rate(FEV1%),maximum ventilation volume per minute( MVV) and the incidence of pulmonary infection were compared respectively between the two groups before and after 2 weeks of treatment. The recurrence rates of stroke in two groups were observed after3 months. Results After 2 weeks of treatment,FVC,FEV1,FEV1% and MVV of the two groups were higher than those before the treatment,while the FVC,FEV1,FEV1% and MVV of the observation group were higher than those of the control group(P < 0. 05). After 2 weeks of treatment,the rate of pulmonary infection in the two groups was respective lower than that before the treatment,and the rate of pulmonary infection of the observation group was lower than that of the control group( P < 0. 05).There was no significant difference in the incidence of recurrent stroke between the two groups( P > 0. 05). Conclusion Respiratory muscle training could promote respiratory function recovery and reduce pulmonary infection in stroke patients.
引文
[1] Brogan E,Langdon C,Brookes K,et al. Dysphagia and factors associated with respiratory infections in the first week post stroke[J]. Neuroepidemiology,2014,43(2):140-144.
[2] Brogan E,Langdon C,Brookes K,et al. Respiratory infections in acute stroke:nasogastric tubes and immobility are stronger predictors than dysphagia[J]. Dysphagia,2014,29(3):340-345.
[3]马艳,王小云,岳翔,等.膈肌训练对脑卒中后疲劳患者日常生活活动的影响[J].中华物理医学与康复杂志,2016,38(8):587-590.
[4]阻塞性睡眠呼吸暂停与卒中诊治专家共识组.阻塞性睡眠呼吸暂停卒中诊治专家共识[J].中华内科杂志,2014,53(8):657-664.
[5] Wahl A S,Schwab M E. Finding an optimal rehabilitation paradigm after stroke:enhancing fiber growth and training of the brain at the right moment[J]. Front Hum Neurosei,2014,7(7):911.
[6] Peurala S H,Karttunen A H,Sjogren T,et al. Evidence for the effectiveness of walking training on walking and self-care after stroke:a systematic review and meta-analysis of randomized controlled trials[J]. J Rehabil Med,2014,46(5):387-399.
[7]王依川,冯重睿,张新斐,等.呼吸肌训练用于脑卒中患者的肺康复效果分析[J].世界最新医学信息文摘,2017,17(A0):63-64.
[8]路惠,冯为菊,丁荧,等.头颈部控制及呼吸肌训练在早期脑卒中吞咽障碍患者中的康复疗效观察[J].实用临床医药杂志,2015,19(23):111-112.
[9]王依川,冯重睿,张耿标,等.呼吸肌训练对脑外伤术后卧床患者肺功能的影响[J].世界最新医学信息文摘,2016,16(93):59.
[10]时惠,刘玲,祖菲娅·吐尔迪.阈值压力负荷呼吸肌训练对脑卒中患者康复疗效的Meta分析[J].中国康复理论与实践,2016,22(9):1069-1074.
[11]王小云,马艳,周芳,等.针刺联合呼吸训练对脑卒中患者肺功能的影响[J].中华物理医学与康复杂志,2015,37(10):754-756.
[12]朱伟新,丘卫红,武惠香,等.早期呼吸功能训练对脑卒中后吞咽障碍患者吞咽功能的影响[J].中华物理医学与康复杂志,2015,37(3):187-189.
[13]贾慧敏,葛宣宣,赵庆贺.核心肌群及徒手呼吸功能训练对脑卒中后吞咽障碍的效果[J].中国康复理论与实践,2017,23(3):326-329.
[14] Postma K,Vlemmix L Y,Haisma J A,et al. Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury:an explorative analysis of data from a randomized controlled trial[J]. J Rehabil Med,2015,47(8):722-726.
[15]黄岳,崔利华,刘丽旭,等.脑卒中患者的呼吸功能障碍及其康复[J].中国康复理论与实践,2015,21(9):1055-1057.
[16]田冲,刘玲,周建梅,等.肺康复训练对脑卒中气管切开术后患者的疗效[J].中国康复,2017,32(4):289-292.
[17]苏国栋,刘惠林,黄梦洁,等.呼吸肌训练对急性脑卒中患者运动功能的效果[J].中国康复理论与实践,2016,22(9):1008-1010.
[18]马頔,王维.呼吸训练联合常规康复训练对偏瘫患者功能康复的研究[J].中国康复医学杂志,2016,31(10):1111-1116.
[19] Messaggi-Sartor M,Guillen-SolàA,Depolo M,et al. Inspiratory and expiratory muscle training in subacute stroke:a randomized clinical trial[J]. Neurology,2015,85(7):564-572.
[20]冯菊荣.呼吸肌训练对脑卒中患者呼吸功能的影响[J].西南军医,2017,19(4):318-321.
[21]郭佳宝,朱毅.吸气肌训练的临床研究进展[J].中国康复医学杂志,2014,29(9):888-892.
[2] Brogan E,Langdon C,Brookes K,et al. Respiratory infections in acute stroke:nasogastric tubes and immobility are stronger predictors than dysphagia[J]. Dysphagia,2014,29(3):340-345.
[3]马艳,王小云,岳翔,等.膈肌训练对脑卒中后疲劳患者日常生活活动的影响[J].中华物理医学与康复杂志,2016,38(8):587-590.
[4]阻塞性睡眠呼吸暂停与卒中诊治专家共识组.阻塞性睡眠呼吸暂停卒中诊治专家共识[J].中华内科杂志,2014,53(8):657-664.
[5] Wahl A S,Schwab M E. Finding an optimal rehabilitation paradigm after stroke:enhancing fiber growth and training of the brain at the right moment[J]. Front Hum Neurosei,2014,7(7):911.
[6] Peurala S H,Karttunen A H,Sjogren T,et al. Evidence for the effectiveness of walking training on walking and self-care after stroke:a systematic review and meta-analysis of randomized controlled trials[J]. J Rehabil Med,2014,46(5):387-399.
[7]王依川,冯重睿,张新斐,等.呼吸肌训练用于脑卒中患者的肺康复效果分析[J].世界最新医学信息文摘,2017,17(A0):63-64.
[8]路惠,冯为菊,丁荧,等.头颈部控制及呼吸肌训练在早期脑卒中吞咽障碍患者中的康复疗效观察[J].实用临床医药杂志,2015,19(23):111-112.
[9]王依川,冯重睿,张耿标,等.呼吸肌训练对脑外伤术后卧床患者肺功能的影响[J].世界最新医学信息文摘,2016,16(93):59.
[10]时惠,刘玲,祖菲娅·吐尔迪.阈值压力负荷呼吸肌训练对脑卒中患者康复疗效的Meta分析[J].中国康复理论与实践,2016,22(9):1069-1074.
[11]王小云,马艳,周芳,等.针刺联合呼吸训练对脑卒中患者肺功能的影响[J].中华物理医学与康复杂志,2015,37(10):754-756.
[12]朱伟新,丘卫红,武惠香,等.早期呼吸功能训练对脑卒中后吞咽障碍患者吞咽功能的影响[J].中华物理医学与康复杂志,2015,37(3):187-189.
[13]贾慧敏,葛宣宣,赵庆贺.核心肌群及徒手呼吸功能训练对脑卒中后吞咽障碍的效果[J].中国康复理论与实践,2017,23(3):326-329.
[14] Postma K,Vlemmix L Y,Haisma J A,et al. Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury:an explorative analysis of data from a randomized controlled trial[J]. J Rehabil Med,2015,47(8):722-726.
[15]黄岳,崔利华,刘丽旭,等.脑卒中患者的呼吸功能障碍及其康复[J].中国康复理论与实践,2015,21(9):1055-1057.
[16]田冲,刘玲,周建梅,等.肺康复训练对脑卒中气管切开术后患者的疗效[J].中国康复,2017,32(4):289-292.
[17]苏国栋,刘惠林,黄梦洁,等.呼吸肌训练对急性脑卒中患者运动功能的效果[J].中国康复理论与实践,2016,22(9):1008-1010.
[18]马頔,王维.呼吸训练联合常规康复训练对偏瘫患者功能康复的研究[J].中国康复医学杂志,2016,31(10):1111-1116.
[19] Messaggi-Sartor M,Guillen-SolàA,Depolo M,et al. Inspiratory and expiratory muscle training in subacute stroke:a randomized clinical trial[J]. Neurology,2015,85(7):564-572.
[20]冯菊荣.呼吸肌训练对脑卒中患者呼吸功能的影响[J].西南军医,2017,19(4):318-321.
[21]郭佳宝,朱毅.吸气肌训练的临床研究进展[J].中国康复医学杂志,2014,29(9):888-892.