摘要
目的探讨体外膈肌起搏联合肺康复训练对脑卒中亚急性期患者肺功能和膈肌功能的影响。方法选取2021-08—2022-10于南京医科大学附属南京医院诊治的脑卒中亚急性期患者80例,采用随机数字表法分为实验组(40例)和对照组(40例)。实验组采用体外膈肌起搏联合肺康复训练治疗,对照组仅采用肺康复训练治疗。所有患者均治疗3周,比较2组治疗前后肺功能、膈肌功能相关指标。结果治疗3周后,2组第1秒用力呼气容积(FEV_(1))[(2.07±0.45)L比(2.63±0.41)L,(2.11±0.47)L比(2.42±0.33)L]、用力肺活量(FVC)[(2.31±0.46)L比(2.77±0.38)L,(2.35±0.39)L(2.56±0.31)L]、FEV_(1)/FVC[(81.41±7.55)%比(89.25±6.43)%,(81.29±6.87)%比(85.12±5.32)%]、峰值呼气流量[(1.81±0.23)L/s比(3.15±0.57)L/s,(1.78±0.44)L/s比(2.54±0.41)L/s]、最大自主通气量[(61.78±7.49)L/min比(78.69±5.69)L/min,(60.25±6.59)L/min比(69.43±6.31)L/min]、动脉血氧分压[(65.47±7.23)mmHg比(94.47±6.53)mmHg,(66.33±6.01)mmHg比(85.29±5.77)mmHg]较治疗前均明显提高,且实验组高于对照组(均P<0.05)。治疗3周后,2组膈肌厚度[(0.19±0.05)cm比(0.25±0.03)cm,(0.20±0.02)cm比(0.22±0.01)cm]、平静呼吸膈肌活动度[(1.25±0.17)cm比(1.46±0.26)cm,(1.27±0.22)cm比(1.36±0.14)cm]、深呼吸膈肌活动度[(2.85±0.36)cm比(3.56±0.44)cm,(2.91±0.34)cm比(3.25±0.31)cm]较治疗前均明显提升,且实验组高于对照组(均P<0.05)。结论体外膈肌起搏联合肺康复训练治疗可明显改善脑卒中亚急性期患者的肺功能和膈肌功能。
Objective To explore the effect of vitro diaphragm pacing combined with pulmonary rehabilita⁃tion training on lung function and diaphragm function in patients with subacute stroke.Methods A total of 80 pa⁃tients with subacute stroke treated in of Affiliated Nanjing Hospital of Nanjing Medical University from August 2021 to October 2022 were selected and divided into experimental group(40 cases)and control group(40 cases)by ran⁃dom number table.The experimental group was treated by vitro diaphragm pacing combined with pulmonary rehabili⁃tation training,while the control group was only treated by pulmonary rehabilitation training.All patients were treated for 3 weeks,and lung function and diaphragm function related indicators were compared between the two groups be⁃fore and after treatment.Results After 3 weeks of treatment,1 s forced expiratory volume(FEV_(1))[(2.07±0.45)L vs(2.63±0.41)L,(2.11±0.47)L vs(2.42±0.33)L],forced vital capacity(FVC)[(2.31±0.46)L vs(2.77±0.38)L,(2.35±0.39)L vs(2.56±0.31)L],FEV_(1)/FVC[(81.41±7.55)%vs(89.25±6.43)%,(81.29±6.87)%vs(85.12±5.32)%],peak expiratory flow[(1.81±0.23)L/s vs(3.15±0.57)L/s,(1.78±0.44)L/s vs(2.54±0.41)L/s],maximum spontaneous ventilation[(61.78±7.49)L/min vs(78.69±5.69)L/min,(60.25±6.59)L/min vs(69.43±6.31)L/min]and partial oxygen pressure of arterial blood[(65.47±7.23)mmHg vs(94.47±6.53)mmHg,(66.33±6.01)mmHg vs(85.29±5.77)mmHg]were significantly increased in both groups compared to before treatment,and the experimental group were higher than the control group(all P<0.05).After 3 weeks of treatment,the thickness of the diaphragm[(0.19±0.05)cm vs(0.25±0.03)cm,(0.20±0.02)cm vs(0.22±0.01)cm],the activity of the calm breathing dia⁃phragm[(1.25±0.17)cm vs(1.46±0.26)cm,(1.27±0.22)cm vs(1.36±0.14)cm],and the activity of the deep breathing diaphragm[(2.85±0.36)cm vs(3.56±0.44)cm,(2.91±0.34)cm vs(3.25±0.31)cm]were signifi⁃cantly improved in both groups compared to before treatment,and the experimental group were higher than the
作者
张会慧
杨婷
俞长君
蒋庆新
朱磊
高政
ZHANG Huihui;YANG Ting;YU Changjun;JIANG Qingxin;ZHU Lei;GAO Zheng(Affiliated Nanjing Hospital of Nanjing Medical University/Nanjing First Hospital,Nanjing 210000,China)
出处
《中国实用神经疾病杂志》
2023年第9期1146-1150,共5页
Chinese Journal of Practical Nervous Diseases
基金
江苏省卫生健康委科研项目(编号:S2020071)
南京市卫生科技发展专项资金项目(编号:YKK20106)。
关键词
脑卒中
体外膈肌起搏
肺康复训练
肺功能
膈肌功能
Stroke
Vitro diaphragm pacing
Pulmonary rehabilitation training
Lung function
Diaphragm function
