体外膈肌起搏联合呼吸训练对脑卒中恢复期患者呼吸肌的影响

Effects of external diaphragm pacing combined with respiratory training on respiratory muscles of stroke patients in recovery period

目的探讨体外膈肌起搏器联合呼吸训练对脑卒中恢复期患者呼吸肌肌群的影响。方法将符合入选标准的40例脑卒中恢复期呼吸功能障碍的患者随机分为呼吸训练组(n=20)和联合治疗组(n=20),两组患者均接受常规康复治疗,呼吸训练组在此基础上予以呼吸训练治疗,联合训练组在呼吸训练组的基础上予以体外膈肌起搏器治疗,分别评估两组患者在治疗6周前后膈肌位移、膈肌及腹肌厚度变化率等各项指标和两组患者各项指标治疗前后的差值,并进行对比分析。结果经过6周的治疗,两组患者的膈肌位移均较治疗前增大,膈肌厚度变化率和腹肌厚度变化率也较治疗前增加。两组相比较,联合治疗组的膈肌位移、膈肌厚度变化率、腹肌厚度变化率等指标治疗前、后的差值较呼吸训练组大(P<0.05)。结论脑卒中恢复期呼吸功能障碍的患者进行体外膈肌起搏器联合呼吸训练治疗后各项指标优于呼吸训练治疗。体外膈肌起搏器联合呼吸训练能够更快更好地促进患者呼吸肌肌力的恢复,提高肺功能,增强核心肌群力量。

Objective To investigate the effect of external diaphragm pacing combined with respiratory training on respiratory muscle groups in patients with stroke recovery period.Methods Forty patients with respiratory dysfunction during stroke recovery period who met the inclusion criteria were randomly divided into respiratory training group(n=20)and the combined treatment group(n=20),both groups received conventional rehabilitation therapy,the respiratory training group was given respiratory training treatment on the basis of this,and the combined training group was given extracorporeal diaphragm lift on the basis of the respiratory training group.After 6 weeks of treatment,the indicators such as diaphragm displacement,diaphragm and abdominal muscle thickness change rate,and the differences between the two groups of patients before and after treatment were measured and compared.Results After 6 weeks of treatment,the displacement of diaphragm in both groups increased compared with before treatment,and the change rate of diaphragm thickness and abdominal muscle thickness also increased compared with before treatment.Comparing the two groups,the difference of diaphragm displacement,diaphragm thickness change rate,abdominal muscle thickness change rate before and after treatment in the combined treatment group was larger than those in the respiratory training group(P<0.05).Conclusion For patients with respiratory dysfunction in the convalescent period of stroke,the external diaphragm pacing combined with respiratory training is better than the respiratory training treatment.Therefore,the external diaphragm pacing combined with respiratory training can promote the breathing of patients faster and better.Recovery of muscle strength,improvement of lung function,and enhancement of core muscle strength.