电动起立床对脑卒中气管切开患者膈肌运动功能的影响

Effects of electric standing bed on diaphragmatic motion function in stroke patients with tracheostomy

目的:基于电动起立床探讨不同倾斜角度对脑卒中气管切开患者膈肌运动功能的影响。方法:选取2021年8-10月来自深圳市第二人民医院36例脑卒中气管切开患者和36例健康人。采用重复测量的试验设计,两组受试者随机被电动起立床放置于3种不同的倾斜角度(0°、30°、和60°)后,由同一名有经验的检查者应用超声测量平静呼吸时的膈肌移动度和平静呼气末的膈肌厚度。结果:①倾斜角度间比较:两组受试者结果均提示,随着电动起立床倾斜角度的增高,膈肌移动度和厚度均有不同程度的增加,每两个倾斜角度之间的膈肌移动度和厚度比较都有显著性差异(P<0.01)。②组别间比较:在3种不同倾斜角度下,健康人膈肌移动度和膈肌厚度明显高于脑卒中患者(P<0.05),且健康人比脑卒中气管切开患者不同倾斜角度之间膈肌移动度和膈肌厚度变化更明显。③亚急性期和慢性期两组病程之间脑卒中气管切开患者膈肌移动度和厚度无显著性差异(P>0.05)。结论:脑卒中气管切开患者膈肌移动度和厚度较健康人下降,电动起立床可有效改善脑卒中气管切开患者的膈肌移动度和厚度,有临床应用价值。

Objective:To investigate the effect of different tilting of electric standing bed on diaphragmatic function in stroke patients with tracheotomy and healthy subjects.Method:From May to September 2021,36 stroke patients with tracheotomy and 36 healthy subjects were selected from Shenzhen Second People's Hospital.Two groups of subjects were randomly placed on electric standing bed at three different positions(0°,30°and 60°tilt).The diaphragmatic degree of excursion during quiet breathing and diaphragmatic thickness at the end of expiratory were measured using ultrasound by the same experienced operator.Result:①Comparison between positions:the results of the two groups indicated that with the increase of electric bed tilt angle diaphragmatic excursion and thickness also increased,and there were significant differences between postures(P<0.01).②Comparison between groups:on three body positions,the diaphragmatic excursion and thickness at the end of expiratory were significantly higher in healthy subjects than those in stroke patients with tracheostomy(P<0.05),and the changes between different body positions in healthy subjects were more significant compared with stroke patients with tracheostomy.③There were no significant differences in diaphragmatic excursion and thickness between the subacute and chronic stage(P>0.05).Conclusion:The diaphragmatic function of the stroke patients with tracheostomy is lower than that of healthy subjects,and the more erected position the more effective in stroke patients with tracheostomy,which has clinical application value.