体外膈肌起搏治疗联合腹肌电刺激对脑卒中患者呼吸功能的效果  

Effect of external diaphragm pacing therapy combined with abdominal functional electrical stimulation on respiratory function for stroke patients

作　　者：乔魏 刘苏[1] 王莹[1] 侯婷婷 宋思瑾 王司晔[1] 孙丽[1] 张莹莹[1] QIAO Wei;LIU Su;WANG Ying;HOU Tingting;SONG Sijin;WANG Siye;SUN Li;ZHANG Yingying(Department of Rehabilitation Medicine,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China;Dalian Medical University,Dalian,Liaoning 116044,China)

机构地区：[1]南通大学附属医院康复医学科,江苏南通市226001 [2]大连医科大学,辽宁大连市116044

出　　处：《中国康复理论与实践》2023年第1期104-109,共6页Chinese Journal of Rehabilitation Theory and Practice

基　　金：南通市科技计划项目(No.MSZ2022116,No.MSZ19240)。

摘　　要：目的探讨体外膈肌起搏治疗联合腹肌电刺激对脑卒中患者呼吸功能的疗效。方法选取2020年10月至2022年9月南通大学附属医院康复医学科脑卒中患者54例,随机分为对照组(n=18)、体外膈肌起搏组(n=18)和联合治疗组(n=18)。3组均接受常规呼吸训练,体外膈肌起搏组增加体外膈肌起搏治疗,联合治疗组联合应用体外膈肌起搏和腹肌电刺激治疗,共2周。治疗前后采用肺功能检测仪检测用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)、呼气峰流速(PEF)、最大吸气压(MIP)和最大呼气压(MEP),超声检测膈肌活动度和膈肌厚度。结果对照组3例、体外膈肌起搏组2例、联合治疗组1例脱落。治疗后,3组FVC、FEV1、PEF、MIP、MEP和膈肌活动度均有明显改善(|t|>3.366,P<0.01),联合治疗组和体外膈肌起搏组FVC、FEV1、MIP和膈肌活动度优于对照组(P<0.05),联合治疗组FVC和FEV1高于体外膈肌起搏组(P<0.05)。结论体外膈肌起搏治疗可以改善脑卒中患者的肺通气和吸气肌肌力,膈肌运动增强;联合腹肌电刺激后肺通气功能改善更为显著。Objective To explore the effect of external diaphragm pacing therapy combined with abdominal functional electrical stimulation on respiratory function for stroke patients.Methods From October,2020 to September,2022,54 stroke patients were randomly divided into control group(n=18),external diaphragm pacing group(n=18)and combined treatment group(n=18).All the groups received breathing training,while the external diaphragm pacing group received external diaphragm pacing therapy,and the combined treatment group received external diaphragm pacing and abdominal functional electrical stimulation therapy,for two weeks.They were measured forced vital capacity(FVC),forced expiratory volume in first second(FEV1),ratio of forced expiratory volume in first second in forced vital capacity(FEV1/FVC),peak expiratory flow(PEF),maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP)with pulmonary function instrument;measured diaphragmatic excursion(DE)and diaphragmatic thickness(DT)with ultrasound,before and after treatment.Results Three cases in the control group,two cases in the external diaphragm pacing group and one case in the combined treatment group dropped off.The FVC,FEV1,PEF,MIP,MEP and DE improved in all the groups(|t|>3.366,P<0.01)after treatment;and the FVC,FEV1,MIP and DE increased more in the combined treatment group and the external diaphragm pacing group than in the control group(P<0.05);the FVC and FEV1increased more in the combined treatment group than in the external diaphragm pacing group(P<0.05).Conclusion External diaphragm pacing therapy may improve ventilation and inspiratory muscle strength,and increase diaphragm movement for stroke patients;while the ventilation improved more after combining with abdominal functional electrical stimulation.

关 键 词：脑卒中 体外膈肌起搏 腹肌 电刺激 呼吸功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]