肺康复在缺血性脑卒中早期康复中的价值

Value of pulmonary rehabilitation in early rehabilitation of patients with ischemic stroke

目的:探讨肺康复在缺血性脑卒中患者早期康复中的疗效。方法:招募2016年1月—2017年1月符合病例选择标准的20例缺血性脑卒中患者,随机分为对照组(10例)和肺康复组(10例)。肺康复组在常规康复治疗基础上联合肺康复,对照组仅接受常规康复治疗,疗程均为4周。比较2组患者干预前后的生活质量、抑郁情绪、最大吸气压(maximum inspiratory pressure,PImax)、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分和肌力引出率。结果:干预后,肺康复组的生理功能、生理疼痛、活力、社会功能和精神健康评分均显著高于对照组(P <0.05),但生理职能、总体健康和情感职能评分的差异无统计学意义(P> 0.05)。干预后,肺康复组的汉密尔顿抑郁量表评分显著低于对照组(P <0.05)。干预后,肺康复组的PImax显著高于对照组(P <0.05),但NIHSS评分无显著差异(P>0.05)。肺康复组和对照组干预后的肌力引出率均显著高于干预前(P <0.05)。结论:肺康复可以改善缺血性脑卒中患者的生活质量、抑郁情绪和呼吸功能,对运动功能的改善也显示出积极的作用。

Objective: To explore the effect of pulmonary rehabilitation on early rehabilitation of patients with ischemic stroke.Methods: Twenty patients with ischemic stroke who met the selection criteria from January2016 to January 2017 were recruited and randomly divided into control group(n = 10) and pulmonary rehabilitation group(n = 10). The pulmonary rehabilitation was administered on the basis of routine rehabilitation treatment for 4 weeks in pulmonary rehabilitation group,and 4 weeks of routine rehabilitation treatment alone was administered in control group.The quality of life, depression, maximum inspiratory pressure(PImax), National Institute ofHealth Stroke Scale(NIHSS) score and the muscle strength extraction rate were compared between the two groups before and after intervention.Results: After intervention, the scores of physiological function, physiological pain, vitality,social function and mental health in the pulmonary rehabilitation group were significantly higher than those in the control group(all P < 0.05), but there were no significant differences in the scores of physiological role, general health and emotional function(all P > 0.05). After intervention, the score of Hamilton Depression Scale in the pulmonary rehabilitation group was significantly lower than that in the control group(P < 0.05). After intervention, PImax in pulmonary rehabilitation group was significantly higher than that in control group(P <0.05), but there was no significant difference in NIHSS score(P > 0.05). The muscle strength extraction rates of pulmonary rehabilitation group and control group after intervention were both significantly higher than those before intervention(both P < 0.05).Conclusion: Pulmonary rehabilitation therapy combined with routine rehabilitation therapy can effectively improve the quality of life, depression and respiratory function of patients in the rehabilitation process of stroke.