Clinical Effect of MHI on Kiaphragm Movement and Lung Function in Stroke Patients
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摘要:
目的 观察人工膨肺（manual hyperinflation，MHI）对脑卒中患者膈肌运动和肺功能状态的影响。 方法 选取脑卒中患者67名，随机分为治疗组（n = 35）和对照组（n = 32）。治疗组采用MHI联合常规康复治疗，对照组采用常规康复治疗，共8周，分别于治疗前，治疗后4周、8周采用进行B超下观察膈肌运动幅度观察、FVC、FEV1评估肺功能、Barthel指数评估日常生活能力。 结果 FVC（L）、FEV1（L）、膈肌运动幅度及Barthel指数程度的组内比较：从干预前、干预4周后至干预8周后，治疗组指标是不断改善的（P < 0.05），组间比较：干预8周后，治疗组各项指标均优于对照组（P < 0.05）。 结论 MH技术可改善脑卒中患者的膈肌活动度、肺功能以及日常生活能力。 Abstract:Objective To observe the effect of MHI （Manual Hyperinflation） on diaphragmatic movement and pulmonary function in stroke patients. Methods 67 stroke patients were randomly divided into treatment group （n = 35） and control group （n = 32）. The treatment group received MHI combined with conventional rehabilitation therapy, and the control group received conventional rehabilitation therapy for 8 weeks. All the patients were assessed with diaphragmatic motion with ultrasound, lung function （FEV1, FVC） and Barthel Index （BI） before, four weeks and eight weeks after treatment. Results Intra-group comparison of FVC （L）, FEV1 （L）, phrenic motion amplitude and Barthel index: Indicators in the treatment group were continuously improved from before intervention, 4 weeks after intervention, to 8 weeks after intervention （P < 0.05）. comparison among groups: After intervention for 8 weeks, all indexes in the treatment group were better than those in the control group （P < 0.05）. Conclusion MH technique can improve the activity of diaphragm, lung function and daily living ability of stroke patients. -
Key words:
- Stroke /
- MHI /
- Chest physiotherapy; Lung function /
- Diaphragmatic muscle
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表 1 2组一般资料比较（
$\bar x \pm s $ ）Table 1. Comparison of two groups of general data （
$\bar x \pm s$ ）组别 n 年龄（岁） 性别（男/女，n） 病变性质脑出血/脑梗死（n） 吸烟（n） 吞咽困难（n） 对照组 32 67.1 ± 7.14 12/20 8/24 7 12 治疗组 35 68.2 ± 6.72 19/16 10/25 6 10 t/χ2 0.649 1.895 0.109 0.2394 0.6043 P 0.5182 0.1687 0.7418 0.6247 0.437 
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表 2 两组治疗前后FVC比较（
$ \bar x \pm s$ ）Table 2. Comparison of FVC before and after treatment between of two groups （
$\bar x \pm s $ ）组别 n FVC（L） 治疗前 4周后 8周后 F P 对照组 32 2.63 ± 0.32 2.67 ± 0.33 2.85 ± 0.28 4.551 0.013 治疗组 35 2.60 ± 0.31 2.79 ± 0.31 3.12 ± 0.29 26.31 < 0.0001 t 0.3833 1.535 3.870 P 0.7027 0.1297 0.0003
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表 3 两组治疗前后FEV1比较（
$\bar x \pm s $ ）Table 3. Comparison of FEV1（L）before and after treatment between of two groups （
$\bar x \pm s $ ）组别 n FEV1（L） 治疗前 4周后 8周后 F P 对照组 32 1.83 ± 0.22 1.88 ± 0.28 2.11 ± 0.32 9.340 0.0002 治疗组 35 1.82 ± 0.23 2.07 ± 0.25 2.52 ± 0.30 64.33 < 0.0001 t 0.1815 2.934 5.413 P 0.8566 0.0046 < 0.0001
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表 4 两组治疗前后膈肌运动幅度比较（
$\bar x \pm s $ ）Table 4. Comparison of Diaphragm motion range before and after treatment between of two groups （
$\bar x \pm s $ ）组别 n 膈肌运动幅度（cm） 治疗前 4周后 8周后 F P 对照组 32 1.19 ± 0.41 1.36 ± 0.37 1.55 ± 0.32 7.643 0.0008 治疗组 35 1.17 ± 0.39 1.52 ± 0.43 1.81 ± 0.39 22.05 < 0.0001 t 0.2046 1.625 2.967 P 0.8385 0.1089 0.0042
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表 5 两组治疗前后BI评分比较（
$\bar x \pm s $ ）Table 5. Comparison of BI before and after treatment between of two groups （
$\bar x \pm s $ ）组别 n BI 治疗前 4周后 8周后 F P 对照组 32 22.5 ± 7.69 31.50 ± 6.90 41.75 ± 5.20 66.57 < 0.0001 治疗组 35 24.25 ± 6.93 40.75 ± 6.12 56.75 ± 6.34 220.6 < 0.0001 t 0.9798 5.815 10.52 P 0.3308 < 0.0001 < 0.0001
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