水疗对痉挛型双瘫儿童肺功能的影响

Effects of Hydrotherapy on Pulmonary Function of Children with Spastic Diplegia

目的观察痉挛型双瘫的脑瘫患儿肺功能特点及水疗对其肺功能的影响作用。方法痉挛型双瘫患儿30例,按照自主意愿分为水疗组和对照组。水疗组患儿进行水疗加常规康复训练,对照组患儿只进行常规康复训练。所有患儿治疗前及治疗2个月后进行肺功能测试。水疗组患儿还记录其在水中最长憋气时间。结果所有患儿测量肺活量(VC)、补呼气量(ERV)、深吸气量(IC)、用力肺活量(FVC)、第1秒用力呼气量(FEV1)、每分钟最大通气量(MVV)、峰流速(PEF)测定值均显著低于预计值(P=0.000),1秒率(FEV1/FVC)测定值与预计值相比无显著性差异(P=0.141)。治疗后,所有患儿VC、FVC、FEV1、FEV1/FVC、MVV、PEF测定值及上测定值占预计值的百分比、最长发声时间较治疗前改善(P<0.05)。对照组治疗后ERV、IC测定值及测定值占预计值的百分比较治疗前略有提高,但无显著性差异(P>0.05);水疗组此两值治疗前后比较有显著性差异(P<0.05)。组间比较,两次测定VC、ERV、IC、FVC、FEV1、FEV1/FVC、MVV、PEF值占预计值的百分比之差、最长发声时间的差值均有显著性差异(P<0.05)。水疗组的患儿治疗后,水中最长憋气时间显著延长(P=0.000)。结论痉挛型双瘫患儿的肺功能降低。康复训练能改善患儿肺功能,结合水疗效果更好。

Objective To observe the characteristic of pulmonary function of children with spastic diplegia and the effects of hydrotherapy on it. Methods30 children with spastic diplegia were divided into hydrotherapy group and control group,who received hydrotherapy and routine rehabilitation or routine rehabilitation only. All patients were tested their pulmonary function and the maximum phonation time before and 2 months after treatment. The longest breath holding time in water of the hydrotherapy group were recorded. ResultsThe vital capacity （VC）,expiratory reserve volume （ERV）,inspiratory capacity （IC）,forced vital capacity （FVC）,forced expiratory volume in one second （FEV1）,maximum ventilatory volume （MVV）,peak expiratory flow （PEF） in all the children decreased significantly compared with the predicted value （P=0.000）,but a second rate （FEV1/FVC） didn＇t （P=0.141）. After treatment,the VC,FVC,FEV1,FEV1/FVC,MVV,PEF values and their percentage of predicted value improved （P0.05）,as well as the maximum phonation time （P0.05）. ERV,IC values and their percentage of predicted value improved a little from pre-treatment in the control group （P0.05）,but significantly in the hydrotherapy group （P0.05）. The percentage of predicted value of VC,ERV,IC,FVC,FEV1,FEV1/FVC,MVV,and PEF,and the maximum phonation time improved more in the hydrotherapy group than in the control （P0.05）. The longest breath holding time in water improved in the hydrotherapy group after treatment （P=0.000）. ConclusionThe pulmonary function impaired in spastic diplegic children,and can be improved with the rehabilitation,especially with the hydrotherapy in addition.