王璐,程怡慧,张秀,等.吸气肌训练对亚急性脑卒中患者肺功能及膈肌运动的影响[J].中华物理医学与康复杂志,2020,42(11):987-991
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| 吸气肌训练对亚急性脑卒中患者肺功能及膈肌运动的影响 |
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| DOI：10.3760/cma.j.issn.0254-1424.2020.11.006 |
| 中文关键词: 脑卒中 吸气肌训练 肺功能 膈肌 |
| 英文关键词: Stroke Inspiratory muscles Breathing training Lung function Diaphragm |
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| 中文摘要: |
| 目的 探讨吸气肌训练对亚急性脑卒中患者肺功能及膈肌运动的影响。 方法 选取本院康复医学中心收治的亚急性脑卒中患者30例，按随机数字表法分为对照组和观察组。由于患者原因，有6例患者退出（其中对照组3例，观察组3例），最终有24例患者完成本研究，每组12例。2组患者根据功能障碍情况均接受相应的常规康复训练，观察组在此基础上增加吸气肌训练，每日1次，每次20 min，每周5 d，共训练4周。分别于治疗前和治疗4周后（治疗后），对2组患者采用用力肺活量(FVC)、一秒用力呼气容积（FEV1）和呼气流量峰值（PEF）占预计值百分比评估肺通气功能，采用最大吸气压（MIP）和吸气峰流速（PIF）评估吸气肌功能，通过超声测量患者膈肌移动度以及吸气末膈肌厚度（DTei）和呼气末膈肌厚度（DTee），并计算膈肌增厚率（DTF），分析比较2组患者肺部感染发生率。 结果 治疗前，2组患者的FVC、FEV1、PEF、MIP和PIF以及深呼吸时患侧膈肌移动度和隔肌厚度组间比较，差异均无统计学意义（P>0.05）。治疗后，观察组患者的各观测指标［FVC（84.67±15.97）%、FEV1（79.08±11.46）%、MIP（63.77±23.50）cmH2O、PIF（3.55±1.38）L/s、膈肌移动度（4.80±1.42）cm、DTei（0.59±0.15）cm、DTF（97.29±46.11）%］均较组内治疗前［FVC（57.42±17.84）%、FEV1（56.00±19.16）%、MIP（39.33±18.86 cmH2O、PIF（1.87±0.85）L/s及（3.14±1.24）cm、（0.42±0.10）cm、（54.79±31.38）%］和对照组治疗后［FVC（67.75±22.26）%、FEV1（66.08±17.95）%、MIP（41.73±20.67）cmH2O、PIF（2.32±1.27）L/s及（3.29±1.09）cm、（0.47±0.11）cm、（49.97±44.57）%］有显著提高（P<0.05）。但2组患者治疗后的PEF、DTee、肺部感染发生率等组间比较，差异均无统计学意义（P>0.05）。 结论 吸气肌训练能有效改善亚急性脑卒中患者的肺通气功能、吸气肌功能、膈肌移动度及收缩时膈肌厚度。 |
| 英文摘要: |
| Objective To investigate the effect of inspiratory muscle training on the lung function and diaphragm movement of stroke survivors. Methods Twenty-four stroke survivors were randomly divided into a control group and an experimental group. Both groups were given routine rehabilitation therapy, while the experimental group was additionally provided with 20 minutes of inspiratory muscle training, 5 times per week for 4 weeks. Before and after the treatment, the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) expressed as percentages of the predicted values were used to assess ventilation. The maximum inspiratory pressure (MIP) and peak inspiratory flow (PIF) were used to assess inspiratory muscle function. Diaphragm mobility, as well as the diaphragm′s thickness at the end of expiration (DTee) and inspiration (DTei) and the diaphragm thickening fraction (DTF) were measured using ultrasonography. Any pulmonary infection was also recorded. Results There was no significant difference between the two groups in any of the measurements before treatment. After the intervention the average FVC, FEV1, MIP, PIF, diaphragm mobility, DTei and DTF of the experimental group were all significantly better than before treatment and significantly better than the control group′s averages. However, no significant difference was found in the average PEF or DTee, nor in the rate of pulmonary infection between the two groups. Conclusion Inspiratory muscle training can effectively improve ventilation, inspiratory muscle function, diaphragm mobility and diaphragm thickness at the end of inspiration among stroke survivors. |
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