摘要
目的:探讨体外膈肌起搏器联合呼吸训练对脑瘫患儿肺功能的改善程度。方法:选取2019年1月—2022年4月于河南中医药大学第一附属医院接受治疗的76例痉挛性脑瘫患儿,随机分为联合组(n=39)和常规呼吸训练组(n=37),常规呼吸训练组患儿行常规康复治疗,联合组在此基础上进行体外膈肌起搏器治疗。测量两组受试者治疗前后的肺活量占预计值百分比(VC%)、用力肺活量占预计值百分比(FVC%)、第1秒用力呼气容积占预计值百分比(FEV_(1)%)、1秒率(FEV_(1)/FVC)、最大通气量占预计值百分比(MVV%)指标,记录患儿最长发声时间(MPT)、平均肌力指数、最大肌力指数、平均吸气峰流速、最大吸气峰流速水平。结果:两组患儿治疗前的VC%、FVC%、FEV_(1)%、FEV_(1)/FVC、MVV%指标差异无统计学意义(P>0.05),而两组患者治疗后的VC%、FVC%、FEV_(1)%、MVV%水平均较治疗前有显著改善(P<0.05),且联合组改善程度显著高于常规呼吸训练组(P<0.05);两组患儿治疗前MPT、平均肌力指数、最大肌力指数、平均吸气峰流速、最大吸气峰流速指标差异均无统计学意义(P>0.05),而治疗后,联合组患儿的上述指标显著高于常规康复组(P<0.05)。结论:体外膈肌起搏器联合呼吸训练可有效改善脑瘫患儿的肺通气功能、改善患儿的音量,增强其呼吸肌力及核心稳定性,值得临床上推广使用。
Objective:To explore the improvement of pulmonary function in children with cerebral palsy by extracorporeal diaphragm pacemaker combined with respiratory training.Methods:Seventy⁃six chil⁃dren with spastic cerebral palsy treated in our hospital were randomly grouped into respiratory training group(n=39)and routine training group(n=37).The children in routine training group received rou⁃tine rehabilitation treatment,and the respiratory training group received extra extracorporeal dia⁃phragm pacemaker treatment on this basis.The percentage of vital capacity to the expected value(VC%),percentage of forced vital capacity to the expected value(FVC%),percentage of forced expiratory volume in the first second to the expected value(FEV_(1)%),one second rate(FEV_(1)/FVC)andpercentage of maximum ventilation volume to the expected value(MVV%)of the two groups of sub⁃jects were measured before and after treatment,and the maximal phonation time(MPT),average mus⁃cle strength index,maximum muscle strength index,average peak inspiratory flow rate and maximumpeak inspiratory flow rate were recorded.Results:No significant difference was found in VC%,FVC%,FEV_(1)%,and MVV%between the two groups before treatment(P>0.05),while the abovepulmonary function indexes in the respiratory training group were significantly higher than those in theroutine training group after treatment(P<0.05).There was no significant difference in the indexes ofMPT,average muscle strength index,maximum muscle strength index,average peak inspiratoryflow rate and maximum peak inspiratory flow rate between the two groups before treatment(P>0.05),but after treatment,the above indexes in the respiratory training group were significantly high⁃er than those in the routine rehabilitation group(P<0.05).Conclusion:Extracorporeal diaphragmpacemaker combined with respiratory training can effectively improve the pulmonary ventilation func⁃tion and enhance the respiratory muscle strength of children with cerebral palsy,which is worthy ofclinical promotion.
作者
官霞
李海峰
王欣刚
GUAN Xia;LI Haifeng;WANG Xingang(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China;School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《武汉大学学报（医学版）》
CAS
2024年第11期1364-1369,共6页
Medical Journal of Wuhan University
基金
河南省卫生健康委资助项目(编号:20-21ZY2172)。
关键词
脑性瘫痪
肺功能
呼吸训练
体外膈肌起搏器
Cerebral Palsy
Lung Function
Breathing Training
Extracorporeal Diaphragm Pacemaker
