深度呼吸训练器联合主动循环呼吸技术护理在下颈段颈髓损伤四肢瘫患者中的应用  

Application of Deep Breathing Trainer Combined with Active Cycleof Breathing Technique Care in Tetraplegic Patients with Lower Cervical Spinal Cord Injury

作　　者：王丽元[1] 方曙静[1] 韩佳俊 吴艳[1] 朱媛媛 宋寒梅 Wang Liyuan;Fang Shujing;Han Jiajun;Wu Yan;Zhu Yuanyuan;Song Hanmei(Department of Orthopedics,The First Affiliated Hospital with Nanjing Medical University·Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院/江苏省人民医院骨科,南京210029

出　　处：《成都医学院学报》2025年第2期336-339,343,共5页Journal of Chengdu Medical College

基　　金：江苏省人民医院“临床能力提升工程”项目计划(No:JSPH-NC-2022-5)。

摘　　要：目的 探讨深度呼吸训练器联合主动循环呼吸技术护理对下颈段颈髓损伤四肢瘫患者肺功能及神经功能的改善作用。方法 选取2023年6月至2024年6月江苏省人民医院下颈段颈髓损伤四肢瘫患者82例作为研究对象,依据随机数字表法将患者分为对照组和试验组,每组41例。对照组行常规康复训练和常规肺康复训练,试验组在对照组基础上加用深度呼吸训练器联合主动循环呼吸技术护理,干预疗程为2个月。比较两组干预前和干预2个月后的负性情绪、疲劳度、日常生活活动能力、肺功能、神经功能及干预期间的并发症。结果 与干预前比较,两组干预2个月后的焦虑自评量表(SAS)、抑郁自评量表(SDS)、疲劳自评量表(FSAS)、Borg评分降低,试验组更低(P<0.05);Barthel指数(BI)、国际神经修复学会脊髓损伤功能评价量表(SCI-FRS)、上、下肢运动评分及第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、最大呼气压(MEP)、最大呼气中断流速(MMEF)升高,试验组更高(P<0.05);针刺觉及轻触觉评分升高(P<0.05),但组间比较差异无统计学意义(P>0.05)。与对照组比较,试验组干预期间的并发症总发生率更低(P<0.05)。结论 深度呼吸训练器联合主动循环呼吸技术护理可有效改善下颈段颈髓损伤四肢瘫患者负性情绪、疲劳度、日常生活活动能力、肺功能及神经功能,并可减少患者并发症的发生,安全性较好。Objective To investigate the effect of deep breathing trainer combined with active cycle of breathing technique care on the improvement of pulmonary function and neurological function in tetraplegic patients with lower cervical spinal cord injury.Methods A total of 82 tetraplegic patients with lower cervical spinal cord injury in Jiangsu Province Hospital from June 2023 to June 2024 were selected as the study objects.They were divided into a control group(n=41)and an experimental group(n=41)according to random number table method.The control group received routine rehabilitation training and routine pulmonary rehabilitation training,while the experimental group was additionally given deep breathing trainer combined with active cycle of breathing technique care on the basis of the treatment in the control group.The intervention lasted for 2 months.The negative emotions,fatigue,daily living activities,pulmonary function,and neurological function before intervention and 2 months after intervention,and the incidence of complications during intervention were compared between the two groups.Results Two months after intervention,the scores of Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Fatigue Self-assessment Scale(FSAS)and Borg in both groups were lower than those before intervention,and the above indicators in the experimental group were lower than those in the control group(P<0.05).The Barthel Index(BI),the International Association of Neurorestoratology Spinal Cord Injury Functional Rating Scale(SCI-FRS)score,the upper and lower extremity motor scores,forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximum expiratory pressure(MEP),and maximum mid-expiratory flow(MMEF)in both groups were elevated,and the above indicators in the experimental group were higher than those in the control group(P<0.05).The scores of needle sensation and light tactile sensation were elevated in both groups(P<0.05),but the difference was not significant when comparing between groups(P>0.05)

关 键 词：四肢瘫 颈髓损伤 深度呼吸训练器 主动循环呼吸技术 肺功能 

分 类 号：R473.6[医药卫生—护理学]