呼吸肌训练对脑卒中患者呼吸功能的影响

Effect of Respiratory Muscle Training on Respiratory Function of the Patients with Strock

目的探讨呼吸肌训练对脑卒中患者呼吸功能的影响。方法选择脑卒中偏瘫患者52例,用随机数字法分为观察组及对照组,每组26例。对照组进行常规康复训练,观察组除常规康复训练外进行呼吸肌训练。比较两组患者治疗前后动脉血气分析(动脉血pH值、PaO_2、PaCO_2数值),肺通气功能测定(FVC、FEV1、FEV1%、PEF、MVV%数值),随访3个月后肺部感染及再发脑卒中的发生率。结果治疗后两组患者的PaO_2、PaCO_2数值之间,FVC、FEV1、FEV1%、PEF、MVV%数值之间,差异具有显著的统计学意义(P<0.05);观察组患者的PaO_2、PaCO_2数值和FVC、FEV1、FEV1%、PEF、MVV%数值,治疗前后的差异具有统计学意义(P<0.05);对照组患者的PaO_2、PaCO_2数值和FVC、FEV1、FEV1%、PEF、MVV%数值,治疗前后的差异也具有统计学意义(P<0.05);观察组的改善情况优于对照组。治疗结束后随访3个月,两组患者的肺部感染率之间,存在显著的统计学差异(χ~2=7.77,P<0.01),而再发脑卒中发生率比较,两组间差异无统计学意义(P>0.05)。结论对脑卒中患者进行及时、有效的呼吸肌训练,能有效改善肺通气功能,提高动脉氧分压,降低二氧化碳分压,促进呼吸功能恢复,降低肺部感染率。

Objective To discuss the effect of respiratory muscle training on respiratory function of the patients with stroke. Methods 52 cases with post stroke hemiplegia were selected and randomly divided into 2 groups： observation group and control group, 26 cases in each; all the cases in both groups received routine rehabilitation training while re- spiratory muscle training was added to cases in observation group; all the cases in both groups received arterial blood gas analysis to detect the values of arterial pH, pressure of arterial oxygen （PaO2） , pressure of arterial carbon dioxide （PaCO2） and pulmonary ventilation function test to detect the values of FVC, FEV1, FEV1% , PEF and MVV% be- fore and after treatment, the results were compared ; the occurrence of pulmonary infection and the reoccurrence of cer- ebral stroke after follow-up for 3 months were compared between the 2 groups. Results After treatment, there existed a great statistical difference in the values of PaO2 and PaCO2and the values of FVC, FEV1, FEVI% , PEF and MVV% between the 2 groups （P 〈0. 05） ; the values of PaO2 and PaCO2and the values of FVC, FEV1, FEVI%, PEF and MVV% of the cases in observation group after treatment were obviously different from those before treatment with statis- tical significance （P 〈 0. 05 ）, same in control group while the improvement in observation group was bigger than that in control group; 3-month follow-up showed that there was an obvious statistical difference in the occurrence of pulmo- nary infection between the 2 groups （χ2 = 7.77, P 〈 0. 01 ） while no statistical difference was found in the reoccur- rence of cerebral stroke between the 2 groups （P 〈 0. 05 ）. Conclusions Immediate and effective respiratory muscle training can obviously improve the pulmonary ventilation function, raise PaO 2 and reduce PaCO2 so as to promote the recovery of respiratory function and decrease the occurrence of pulmonary infection.