临床研究

综合性呼吸训练对颈髓损伤患者呼吸功能的效果

  • 徐东红 ,
  • 何雅琳 ,
  • 朱云霞 ,
  • 丁怡 ,
  • 夏松成 ,
  • 王惠芳
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  • 上海市养志康复医院(上海市阳光康复中心),上海市 201619
徐东红(1968-),女,汉族,浙江衢州市人,副主任医师,主要研究方向:偏瘫与截瘫患者的心肺功能与心肺康复。

收稿日期: 2017-10-10

  修回日期: 2018-01-11

  网络出版日期: 2018-04-27

Effect of Comprehensive Pulmonary Exercise on Respiratory Function of Patients Suffered from Cervical Spinal Cord Injury

  • XU Dong-hong ,
  • HE Ya-lin ,
  • ZHU Yun-xia ,
  • DING Yi ,
  • XIA Song-cheng ,
  • WANG Hui-fang
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  • Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai 201619, China

Received date: 2017-10-10

  Revised date: 2018-01-11

  Online published: 2018-04-27

摘要

目的 观察综合性呼吸训练对颈髓损伤恢复期患者肺功能的短期疗效。方法 2011年11月至2016年12月,颈髓损伤恢复期患者(C3~C6 ASIA A~D级) 100例,随机分对照组和观察组,各50例。对照组进行常规康复训练,观察组在常规康复训练基础上加综合性呼吸训练,共2个月。训练前后采用肺功能仪检查肺活量(FVC)、第一秒用力呼气量(FEV1)、25%肺活量时的最大呼气流量(MEF25%)和每分钟最大通气量(MVV)。结果 训练后,观察组FVC、FEV1、MEF25%和MVV显著改善(t>4.116, P<0.001),且各指标改善显著优于对照组(t>4.390, P<0.001)。结论 综合性呼吸训练对颈髓损伤恢复期患者肺通气功能有明显的短期疗效。

本文引用格式

徐东红 , 何雅琳 , 朱云霞 , 丁怡 , 夏松成 , 王惠芳 . 综合性呼吸训练对颈髓损伤患者呼吸功能的效果[J]. 中国康复理论与实践, 2018 , 24(4) : 467 -471 . DOI: 10.3969/j.issn.1006-9771.2018.04.017

Abstract

Objective To observe the short-term effect of comprehensive pulmonary exercise on the impaired respiratory function of convalescence patients suffered from cervical spinal cord injury.Methods From November, 2011 to December, 2016, 100 patients with cervical spinal cord injury (C3-C6, ASIA A-D) were randomly divided into control group (n=50) and observation group (n=50). The control group received routine rehabilitation training, and the observation group added comprehensive pulmonary exercise. They were examined with forced vital capacity (FVC), forced expiratory volume in first second (FEV1), maximum expiratory flow rate with remaining 25% vital capacity (MEF25%) and maximum ventilation volume (MVV) before and two months after intervention.Results The FVC, FEV1, MEF25% and MVV improved significantly in the observation group (t>4.110, P<0.001), and the D-value was more in the observation group than in the control group before and after intervention (t>4.390, P<0.001). Conclusion Comprehensive pulmonary exercise has short-term effect on pulmonary function in convalescent patients survived from cervical spinal cord injury.

参考文献

[1] Anke A, Aksnes AK, Stanghelle JK, et al.Lung volumes in tetraplegic patients according to cervical spinal cord injury level[J]. Scand J Rehabil Med, 1993, 25(2): 73-77.
[2] West CR, Campbell IG, Shave RE.Resting cardiopulmonary function in paralympic athletes with cervical spinal cord injury[J]. Med Sci Sports Exerc, 2012, 44(2): 323-329.
[3] Johnson KG, Hill LJ.Pulmonary management of the acute cervical spinal cord injured patients[J]. Nurs Clin North Am, 2014, 49(3): 357-369.
[4] Spungen AM, Dicpinigaitis PV, Almenoff PL, et al.Pulmonary obstruction in individuals with cervical spinal cord leisions unmasked by bronchodilator administration[J]. Paraplegia, 1993, 31(6): 404-407.
[5] Brooks D, O'Brien K. Is inspiratory muscle training effective for individuals with cervical spinal cord injury? A qualitative systematic review[J]. Clin Rehabil, 2005, 19(3): 237-246.
[6] Postma K, Haisma JA, Hopman MT, et al.Resistive inspiratory muscle training in people with spinal cord injury during inpatient rehabilitation: a randomized controlled trial[J]. Phys Ther, 2014, 94(12): 1709-1719.
[7] Roth EJ, Stenson KW, Powley S, et al.Expiratory muscle training in spinal cord injury: a randomized controlled trial[J]. Arch Phys Med Rehabil, 2010, 91(6): 857-861.
[8] Wadsworth BM, Haines TP, Cornwell PL, et al.Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis[J]. Spinal Cord, 2009, 47(4): 274-285.
[9] Jackson AP, Haak MH, Khan N, et al.Cervical spinal injuries in the elderly: acute postoperative mortality[J]. Spine, 2005, 30(13): 1524-1527.
[10] Berlowitz DJ, Wadsworth B, Ross J.Respiratory problems and management in people with spinal cord injury[J]. Breathe (Sheff), 2016, 12(4): 328-340.
[11] Jackson AB, Groomes TE.Incidence of respiratory complications following spinal cord injury[J]. Arch Phys Med Rehabil, 1994, 75(3): 270-275.
[12] Como JJ, Sutton ER, Mccunn M, et al.Characterizing the need for mechanical ventilation following cervical spinal cord injury with neurologic deficit[J]. J Trauma, 2005, 59(4): 912-916.
[13] Detroyer A, Estenne M, Heilporn A.Mechanism of active expiration in tetraplegic subjects[J]. N Engl J Med, 1986, 314(12): 740-744.
[14] Hartkopp A, Bronnum-Hansen H, Seidenschnur AM, et al.Survival and cause of death after traumatic spinal cord in injury: a long-term epidemiological survey from Denmark[J]. Spinal Cord, 1997, 35(2): 76-85.
[15] Roth EJ, Stenson KW, Powley S, et al.Expiratory muscle training in spinal cord injury: a randomized controlled trial[J]. Arch Phys Med Rehabil, 2010, 91(6): 857-861.
[16] Brown R, Dimarco AF, Hoit JD, et al.Respiratory dysfunction and management in spinal cord injury[J]. Respir Care, 2006, 51(8): 869-870.
[17] Tamplin J, Berlowitz DJ.A systematic review and meta-analysis of the effects of respiratory muscle training on pulmonary function in tetraplegia[J]. Spinal Cord, 2014, 52(3): 175-180.
[18] Forner JV.Lung volumes and mechanics of breathing in tetraplegics[J]. Paraplegia, 1980, 18(4): 258-266.
[19] Terson de Paleville D, Mckay W, Aslan S, et al. Locomotor step training with body weight support improves respiratory motor function in individuals with chronic spinal cord injury[J]. Respir Physiol Neurobiol, 2013, 189(3): 491-497.
[20] Soyupek F, Savas S, Oztürk O, et al.Effects of body weight supported treadmill training on cardiac and pulmonary functions in the patients with incomplete spinal cord injury[J]. J Back Musculoskelet Rehabil, 2009, 22(4): 213-218.
[21] Donohue JF.Minimal clinically important differences in COPD lung function[J]. COPD, 2005, 2(1): 111-124.
[22] Postman K, Haisma JA, Groot S, et al.Changes in pulmonary function during the early years after inpatient rehabilitation in persons with spinal cord injury: a prospective cohort study[J]. Arch Phys Med Rehabil, 2013, 94(8): 1540-1546.
[23] Haas F, Axen K, Pineda H, et al.Temporal pulmonary function changes in cervical cord injury[J]. Arch Phys Med Rehabil, 1985, 66(3): 139-144.
[24] Carter RE.Unilateral diaphragrnatic paralysis in spinal cord injury patients[J]. Paraplegin, 1980, 18(4): 267-274.
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