肺康复对脑卒中相关性肺炎患者膈肌功能及日常生活活动能力的影响  

The effect of pulmonary rehabilitation on diaphragmatic function and ability of activities of daily living in patients with stroke-related pneumonia

作　　者：马海 刘梅[1] 拜承萍[2] 严小红 赵艳芳[1] 马玥 MA Hai;LIU Mei;BAI Chengping;YAN Xiaohong;ZHAO Yanfang;MA Yue(Department of Rehabilitation Medicine,Qinghai University Affiliated Hospital,Qinghai,Xining 810012,China;Department of Neurology,Qinghai University Affiliated Hospital,Qinghai,Xining 810012,China;School of Clinical Medicine,Qinghai University,Qinghai,Xining 810016,China)

机构地区：[1]青海大学附属医院康复医学科,青海西宁810012 [2]青海大学附属医院神经内科,青海西宁810012 [3]青海大学临床医学院,青海西宁810016

出　　处：《中国医药科学》2024年第1期184-187,共4页China Medicine And Pharmacy

基　　金：青海大学附属医院中青年科研基金项目(ASRF-2020-YB-10)。

摘　　要：目的探讨肺康复对脑卒中相关性肺炎(SAP)患者的膈肌功能及日常生活活动能力的影响,为进一步临床推广应用提供理论依据。方法收集2021年1月至2022年1月在青海大学附属医院康复医学科、重症医学科、急诊ICU、神经外科、神经内科住院的60例明确诊断为SAP的患者,根据随机数表法分为治疗组(n=30)和对照组(n=30)。对照组采用常规康复治疗,治疗组在对照组基础上联合肺康复。治疗2周后,分析两组患者治疗前后的膈肌移动度、膈肌厚度、临床疗效、改良Barthel指数(MBI)评分。结果治疗2周后,治疗组患者的膈肌移动度、膈肌厚度、MBI评分分别为(2.81±0.21)cm、(0.18±0.05)cm、(44.53±17.18)分,均高于对照组患者的膈肌移动度、膈肌厚度、MBI评分(2.52±0.18)cm、(0.14±0.03)cm、(36.40±13.80)分,差异有统计学意义(P<0.05);治疗组的患者临床疗效总有效率高于对照组,差异有统计学意义(P<0.05)。结论对SAP患者采用常规康复训练基础上加上肺康复更加有利于改善患者的膈肌功能及肺炎反应,从而提高患者的日常生活活动能力,加速疾病的恢复。Objective To explore the effect of pulmonary rehabilitation on diaphragmatic function and activity of daily living in patients with stroke-associated pneumonia(SAP),and to provide a theoretical basis for further clinical promotion and application.Methods A total of 60 patients diagnosed with SAP who were hospitalized in the Department of Rehabilitation Medicine,Department of Critical Care Medicine,Emergency ICU,Department of Neurosurgery,and Department of Neurology of Qinghai University Affiliated Hospital from January 2021 to January 2022 were collected and divided into a treatment group(n=30)and a control group(n=30)based on the random number table method.The control group received routine rehabilitation treatment,while the treatment group received pulmonary rehabilitation based on the treatment for the control group.After 2 weeks of treatment,the diaphragmatic mobility,diaphragmatic thickness,clinical efficacy,and modified Barthel index(MBI)scores of both groups of patients were analyzed before and after treatment.Results After 2 weeks of treatment,the diaphragmatic mobility,diaphragmatic thickness,and MBI scores of patients in the treatment group were(2.81±0.21)cm,(0.18±0.05)cm,and(44.53±17.18)points,respectively,which were higher than those of patients in the control group(2.52±0.18)cm,(0.14±0.03)cm,and(36.40±13.80)points,with statistically significant differences(P<0.05).The total effective rate of clinical efficacy in the treatment group was 83.33%,higher than 46.67% in the control group,with statistically significant difference(P<0.05).Conclusion The combination of routine rehabilitation training and pulmonary rehabilitation is more beneficial for improving the diaphragmatic function and pneumonia response in patients with SAP,thereby improving their daily activity of life and accelerating disease recovery.

关 键 词：脑卒中相关性肺炎 肺康复 膈肌移动度 膈肌厚度 日常生活活动能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]