《中国康复理论与实践》

《中国康复理论与实践》

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阈值压力负荷呼吸肌训练对脑卒中患者康复疗效的Meta分析①

时惠，刘玲，祖菲娅·吐尔迪   

  1. 新疆医科大学第一附属医院康复医学科，新疆乌鲁木齐市830054。
  • 出版日期:2016-09-25 发布日期:2016-12-05

Threshold Training of Respiratory Muscles after Stroke: A Meta-analysis

SHI Hui, LIU Ling, Zufeiya TURDI   

  1. Department of Rehabilitation, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, China
  • Published:2016-09-25 Online:2016-12-05

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摘要： 目的评价阈值压力负荷呼吸肌训练对脑卒中患者的康复疗效。方法检索Cochrane 图书馆、PubMed、Medline、Embase、OVID、中国生物医学文献数据库、万方数据库、中国知网全文数据库2005 年1 月~2015 年6 月相关随机对照研究，由2名研究员对文献质量进行严格评价和资料提取，对符合纳入标准的文献进行Meta 分析。结果筛选符合纳入标准的随机对照研究4 项，研究对象共167 例，其中干预组(阈值压力负荷呼吸肌训练组)84 例，对照组83 例。与对照组相比，干预组呼吸肌强度明显改善(最大吸气压：MD=9.46, 95%CI 4.61~14.32, P<0.001。最大呼气压：MD=9.44, 95%CI 2.68~16.20, P=0.006)，并可减少肺部感染的发生率(OR=0.35, 95%CI 0.13~0.97, P=0.04)。结论阈值压力负荷呼吸肌训练法可改善脑卒中患者呼吸肌功能，并在一定程度上减少肺部感染的发生。

关键词: 脑卒中, 阈值压力负荷, 呼吸肌训练, 康复, meta分析

Abstract: Objective To study the effects of threshold training of respiratory muscles on respiratory muscle function and pulmonary infection after stroke with meta-analysis. Methods The randomized controlled trials about threshold training of respiratory muscles in stroke patients in Cochrane Library, PubMed, Medline, Embase, OVID, Chinese Biomedical Database, WanFang database and CNKI full-text database from January, 2005 to June, 2015 were systematically searched. Literatures were evaluated and extracted by two researchers. Results Four studies were included, with a total of 167 cases, 84 cases in the intervention group (threshold training of respiratory muscles) and 83 cases in the control group. Compared with the control group, the intervention might improve the respiratory muscle strength (for maximum inspired pressure, MD=9.46, 95% CI=4.61~14.32, P<0.001; for maximum expired pressure, MD=9.44, 95% CI=2.68~16.20, P=0.006), and decreased pulmonary infection (OR=0.35, 95% CI=0.13~0.97, P=0.04). Conclusion Threshold training of respiratory muscles can improve respiratory muscle function and reduce the incidence of pulmonary infection.

Key words: stroke, pressure threshold load, respiratory muscle training, rehabilitation, meta-analysis