刘西花,杨玉如,张伟,等.脑卒中患者呼吸肌功能障碍及影响因素分析[J].中华物理医学与康复杂志,2021,43(8):686-689
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| 脑卒中患者呼吸肌功能障碍及影响因素分析 |
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| DOI：10.3760/cma.j.issn.0254-1424.2021.08.003 |
| 中文关键词: 脑卒中 呼吸肌功能 吞咽障碍 运动功能 影响因素 |
| 英文关键词: Stroke Respiratory muscle function Dysphagia Motor function |
| 基金项目:国家自然科学基金(81802239) |
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| 中文摘要: |
| 目的 分析脑卒中患者呼吸肌功能及其影响因素，为临床康复干预提供参考依据。 方法 选取2018年12月至2020年4月山东中医药大学附属医院康复科收治的脑卒中患者139例，根据吸气肌肌力百分比（实际肌力指数/预计肌力指数）将患者分为呼吸肌功能障碍组（<50%）和对照组（≥50%）。收集所有患者的基本资料，包括年龄、性别、病程、脑卒中类型、脑卒中部位、生活习惯（吸烟饮酒史）、身体质量指数（BMI），以及是否有吞咽障碍、高血压、糖尿病、冠心病史，采用简化Fugl-Meyer运动功能评估量表(FMA)和简化Berg平衡量表(BBS)评定患者的运动和平衡能力。采用多因素Logistic回归分析法探讨脑卒中患者呼吸肌功能障碍的影响因素。 结果 139例患者中，呼吸肌功能障碍者81例（占58.27%）。单因素分析显示，脑卒中部位（是否涉及脑干）、是否伴有吞咽障碍、FMA评分和BBS评分是脑卒中患者呼吸功能障碍的影响因素(P＜0.05)。多因素Logistic回归分析表明，伴有吞咽障碍、FMA评分和BBS评分是脑卒中患者呼吸肌功能障碍的独立影响因素（P＜0.05），其中伴有吞咽障碍为危险因素，FMA评分和BBS评分高为保护性因素。 结论 脑卒中后部分患者会存在呼吸肌功能障碍，伴有吞咽障碍为呼吸肌功能障碍的危险因素，而FMA评分和BBS评分高是其保护性因素。 |
| 英文摘要: |
| Objective To analyze the respiratory muscle functioning of stroke survivors and explore factors influencing it so as to provide references for clinical rehabilitation intervention. Methods A total of 139 stroke survivors were randomly divided into a respiratory muscle dysfunction group and a control group based on the actual strength of their inspiratory muscles divided by the predicted strength. Beyond typical clinical data, information was collected about the subjects′ exercise habits. Balance ability was evaluated using the Fugl-Meyer assessment scale (FMA) and the simplified Berg Balance Scale (BBS). Multivariate logistic regression was used to analyze the factors influencing respiratory muscle dysfunction. Results Among the 139 patients, 81 (58.27%) had respiratory muscle dysfunction. Univariate analysis showed that patients with stroke in the brainstem and dysphagia and those with poor FMA and BBS scores were at significantly greater risk of respiratory muscle dysfunction. Logistic regression analysis showed that dysphagia, FMA and BBS scores were factors independently predicting respiratory muscle dysfunction among stroke survivors, with dysphagia as a risk factor, and high FMA and BBS scores as protective factors. Conclusion Some stroke survivors may have respiratory muscle dysfunction, and dysphagia is a risk factor, while the high FMA and BBS scores are protective. |
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