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呼吸锻炼预防脑卒中后肺部感染的可行性研究 被引量:8

A study on the feasibility of respiratory muscle training to prevent pulmonary infection after stroke
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摘要 目的评价呼吸锻炼预防卒中相关性肺炎(SAP)的可行性。方法选择2015年3月-2017年12月在我院就诊的脑卒中患者98例,随机分为呼气训练组33例、吸气训练组32例和对照组33例,分布给予吸气性呼吸肌锻炼(RMT)、呼气性RMT和空白RMT治疗,疗程90d,比较治疗后自发性咳嗽呼气期峰流速(PECF)、辣椒素诱导的非自发性咳嗽PECF、呼吸最大气流值(PImax和PEmax),同时记录肺炎发生率。结果三组各有3例(9. 09%)、1例(3. 13%)和3例(9. 09%)发生肺炎,组间比较差异无统计学意义(χ~2=1. 157,P=0. 561);三组治疗后自发性咳嗽PECF、非自发性咳嗽PECF不同时点比较差异无统计学意义(P>0. 05),而PEmax和PImax均有升高(P <0. 05),其中治疗后28d和90d均大于治疗前(P <0. 05); PECF、PECF差值和PECF下降比例组间比较差异无统计学意义(P> 0. 05),治疗后PEmax和PImax、差值和下降比例组间比较差异均无统计学意义(P> 0. 05)。结论急性脑卒中患者进行RMT无法减少SAP,也不能改善呼吸肌和咳嗽功能。 Objective To evaluate the feasibility of respiratory muscle training(RMT)to prevent stroke associated pneumonia(SAP).Methods From March 2015 to December 2017,98 stroke patients in our hospital were randomly divided into the expiratory training group(n=33),the inspiratory training group(n=32)and the control group(n=33).The treatment course was 90d.The peak expiratory cough flow(PECF)of voluntary cough,PECF of capsaicin induced non voluntary cough,maximal mouth pressure(PImax and PEmax)after treatment were compared.Results 3 cases(9.09%),1 case(3.13%)and 3 cases(9.09%)of pneumonia occurred in each group,there was no significant difference between groups(χ^2=1.157,P=0.561).There was no significant difference in voluntary cough PECF and involuntary cough PECF after treatment in three group(P>0.05).PEmax and PImax increased(P<0.05),while value of 28d and 90d after treatment were higher than baseline(P<0.05).There was no significant difference in PECF,change of PECF and percentage change from baseline of PECF between the two groups(P>0.05).There was no significant significant in PEmax,PImax,change and decrease propotion after treatment between the two groups(P>0.05).Conclusion RMT can not reduce SAP of acute stroke and can't improve the function of respiratory muscle and cough.
作者 王金娟 张卫卫 WANG Jin-juan;ZHANG Wei-wei(the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shanxi 710004,China)
出处 《临床肺科杂志》 2019年第2期308-311,316,共5页 Journal of Clinical Pulmonary Medicine
关键词 脑卒中 肺炎 呼吸锻炼 咳嗽功能 stroke pneumonia breathing exercise cough function
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