基于电阻抗断层成像技术评估膈神经-腹肌电刺激对脑卒中患者肺通气分布的效果

doi:10.3969/j.issn.1006-9771.2026.05.007

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (5): 571-576.doi: 10.3969/j.issn.1006-9771.2026.05.007

基于电阻抗断层成像技术评估膈神经-腹肌电刺激对脑卒中患者肺通气分布的效果

陈竹^1a, 翟丽茹^1b, 曹存霞^1b, 彭晓华^1b(), 黄桃^1a()

¹ 重庆医科大学附属第一医院， a. 急诊医学科；b. 康复医学科，重庆市 400016

收稿日期:2025-10-23 出版日期:2026-05-25 发布日期:2026-05-26
通讯作者: 彭晓华，E-mail：fisherpeng2025@163.com；
黄桃，E-mail：470622696@qq.com
作者简介:陈竹(1990-)，女，汉族，四川南充市人，硕士研究生，主管技师，主要研究方向：心肺与重症康复。
彭晓华(1984-)，女，汉族，山东青岛市人，博士，副主任医师，主要研究方向：重症康复和心肺康复。
黄桃(1976-)，男，汉族，四川自贡市人，硕士，正高级工程师，主要研究方向：重症康复临床研究。
基金资助:
重庆市科学技术局技术创新与应用发展专项重点项目(CSTB2021TIAD-KPX0054)

Effect of phrenic nerve-abdominal muscle electrical stimulation on pulmonary ventilation distribution in stroke patients: a study with electrical impedance tomography

CHEN Zhu^1a, ZHAI Liru^1b, CAO Cunxia^1b, PENG Xiaohua^1b(), HUANG Tao^1a()

¹ a. Department of Emergency Medicine; b. Department of Rehabilitation Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Received:2025-10-23 Published:2026-05-25 Online:2026-05-26
Contact: PENG Xiaohua, E-mail: fisherpeng2025@163.com;
HUANG Tao, E-mail: 470622696@qq.com
Supported by:
Chongqing Municipal Science and Technology Bureau Technological Innovation and Application Development Special Program (Key)(CSTB2021TIAD-KPX0054)

摘要/Abstract

摘要：

目的采用电阻抗断层成像技术(EIT)量化评估膈神经-腹肌电刺激改善脑卒中患者肺通气分布的效果。
方法 2024年9月至2025年6月，于重庆医科大学附属第一医院选取35例脑卒中患者，接受标准化膈神经-腹肌电刺激。于治疗前(T0)，治疗结束时(T1)，治疗后5 min、10 min、15 min、20 min、25 min、30 min、40 min和50 min (T2~T9)，采用EIT监测重力依赖区通气百分比(ROI%)、通气中心(COV)、整体不均一指数(GI)和呼气末肺阻抗变化值(ΔEELI)。
结果不同时间点ROI% (F=7.003, P<0.001)、COV (F=5.722, P <0.001)有显著性差异，均在T1达峰值，随后呈下降趋势，持续至T5；不同时间点GI (F=1.849, P=0.097)和△EELI (F=0.208, P=0.871)无显著性差异，但GI于T7时低于T0 (P<0.05)。
结论膈神经-腹肌电刺激可改善重力依赖区通气，使通气中心向背侧移位，通气分布改善通常于治疗结束时达峰值，并维持约20 min。

关键词: 脑卒中, 肺康复, 膈神经-腹肌电刺激, 电阻抗断层成像技术

Abstract:

Objective To quantitatively evaluate the effect of phrenic nerve-abdominal muscle electrical stimulation on pulmonary ventilation distribution in stroke patients using electrical impedance tomography (EIT).
Methods Thirty-five stroke patients were enrolled at the First Affiliated Hospital of Chongqing Medical University from September, 2024 to June, 2025, and all received standardized phrenic nerve-abdominal muscle electrical stimulation. Percentage of ventilation in gravity-dependent regions of interesting (ROI%), center of ventilation (COV), global inhomogeneity index (GI) and change in end-expiratory lung impedance (ΔEELI) were measured with EIT monitoring before treatment (T0), immediately after treatment (T1), and at five, ten, 15, 20, 25, 30, 40 and 50 minutes after treatment (T2 to T9).
Results There were significant differences in ROI% (F=7.003, P<0.001) and COV (F=5.722, P<0.001) at different time points, both peaking at T1, followed by a downward trend until T5. No significant differences were observed in GI (F=1.849, P=0.097) and ΔEELI (F=0.208, P=0.871) across time points; however, GI at T7 was lower than that at T0 (P<0.05).
Conclusion Phrenic nerve-abdominal muscle electrical stimulation can improve the ventilation ratio in gravity-dependent regions and shift the center of ventilation dorsally. The improvement in ventilation distribution generally peaks at the end of treatment and lasts for approximately 20 minutes.

Key words: stroke, pulmonary rehabilitation, phrenic nerve-abdominal muscle electrical stimulation, electrical impedance tomography

中图分类号:

R743.3

陈竹, 翟丽茹, 曹存霞, 彭晓华, 黄桃. 基于电阻抗断层成像技术评估膈神经-腹肌电刺激对脑卒中患者肺通气分布的效果[J]. 《中国康复理论与实践》, 2026, 32(5): 571-576.

CHEN Zhu, ZHAI Liru, CAO Cunxia, PENG Xiaohua, HUANG Tao. Effect of phrenic nerve-abdominal muscle electrical stimulation on pulmonary ventilation distribution in stroke patients: a study with electrical impedance tomography[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(5): 571-576.

图/表 1

参考文献 31

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时间点	ROI%	GI	COV/%	ΔEELI
T0	45.32±8.15	35.53±2.87	48.96±4.75	-
T1	49.71±8.72^a	35.24±3.12	51.08±5.33^a	-0.14±1.08
T2	47.79±8.39^a,b	35.62±2.92	50.30±4.69^a	-0.20±1.13
T3	48.63±8.93^a	34.87±2.77^c	50.59±5.10^a	-0.30±1.46
T4	46.92±8.52^a,b,d	35.45±2.91	49.82±4.62^a,b	-0.25±1.14
T5	47.17±8.85^a,b,d	34.66±2.47^c,e	49.93±4.99^a,b	-0.25±1.29
T6	46.26±8.61^b,d	34.92±2.91	49.42±4.90^b,d	-0.20±1.42
T7	46.54±8.21^b,d	34.55±2.73^a,b,c	49.61±4.62^b,d	-0.20±1.66
T8	45.85±8.13^b,c,d	35.26±2.88^h	49.26±4.59^b,d	-0.17±1.60
T9	45.52±8.31^b,c,d,f	35.45±2.69^f,h	48.99±4.74^b,c,d	-0.15±1.78
F值	7.003	1.849	5.722	0.208
P值	<0.001	0.097	<0.001	0.871

基于电阻抗断层成像技术评估膈神经-腹肌电刺激对脑卒中患者肺通气分布的效果

Effect of phrenic nerve-abdominal muscle electrical stimulation on pulmonary ventilation distribution in stroke patients: a study with electrical impedance tomography

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