体外膈肌起搏治疗联合腹肌电刺激对脑卒中患者呼吸功能的效果

doi:10.3969/j.issn.1006-9771.2023.01.016

Abstract

Abstract:

Objective To explore the effect of external diaphragm pacing therapy combined with abdominal functional electrical stimulation on respiratory function for stroke patients.

Methods From October, 2020 to September, 2022, 54 stroke patients were randomly divided into control group (n= 18), external diaphragm pacing group (n= 18) and combined treatment group (n= 18). All the groups received breathing training, while the external diaphragm pacing group received external diaphragm pacing therapy, and the combined treatment group received external diaphragm pacing and abdominal functional electrical stimulation therapy, for two weeks. They were measured forced vital capacity (FVC), forced expiratory volume in first second (FEV₁), ratio of forced expiratory volume in first second in forced vital capacity (FEV₁/FVC), peak expiratory flow (PEF), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) with pulmonary function instrument; measured diaphragmatic excursion (DE) and diaphragmatic thickness (DT) with ultrasound, before and after treatment.

Results Three cases in the control group, two cases in the external diaphragm pacing group and one case in the combined treatment group dropped off. The FVC, FEV₁, PEF, MIP, MEP and DE improved in all the groups (|t| > 3.366, P< 0.01) after treatment; and the FVC, FEV₁, MIP and DE increased more in the combined treatment group and the external diaphragm pacing group than in the control group (P< 0.05); the FVC and FEV₁ increased more in the combined treatment group than in the external diaphragm pacing group (P< 0.05).

Conclusion External diaphragm pacing therapy may improve ventilation and inspiratory muscle strength, and increase diaphragm movement for stroke patients; while the ventilation improved more after combining with abdominal functional electrical stimulation.

Key words: stroke, external diaphragm pacing, abdominal muscles, electrical stimulation, respiratory function

CLC Number:

R743.3

QIAO Wei, LIU Su, WANG Ying, HOU Tingting, SONG Sijin, WANG Siye, SUN Li, ZHANG Yingying. Effect of external diaphragm pacing therapy combined with abdominal functional electrical stimulation on respiratory function for stroke patients[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 104-109.

Figures/Tables 9

References 33

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项目	对照组(n = 15)	EDP组(n = 16)	联合治疗组(n = 17)	χ²/F值	P值
性别(男/女)/n	9/6	12/4	14/3	2.003	0.395
年龄/岁	61.47±3.00	59.31±3.45	56.41±3.36	0.594	0.556
BMI/(kg·m^-2) 病程/d 吸烟(无/有)/n 高血压(无/有)/n 糖尿病(无/有)/n 吞咽困难(无/有)/n	23.80±0.90 24.93±5.31 12/3 4/11 9/6 5/10	22.88±0.72 22.63±2.86 9/7 5/11 13/3 6/10	24.69±0.99 20.29±2.06 13/4 4/13 12/5 6/11	1.095 0.428 2.359 0.345 1.686 0.059	0.343 0.655 0.320 0.920 0.485 0.971

组别	n	治疗前	治疗后	t值	P值
对照组	15	1.57±0.16	1.89±0.14	-5.736	< 0.001
EDP组	15	1.76±0.15	2.39±0.15^a	-5.356	< 0.001
联合治疗组	16	1.99±0.17	2.91±0.18^a,b	-8.341	< 0.001
F值 P值		1.735 0.189	10.450 < 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	15	1.15±0.12	1.44±0.11	-4.257	0.001
EDP组	15	1.32±0.10	1.85±0.10^a	-9.075	< 0.001
联合治疗组	16	1.51±0.14	2.23±0.14^a,b	-7.435	< 0.001
F值 P值		2.144 0.130	11.414 < 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	15	0.75±0.04	0.77±0.04	-0.890	0.388
EDP组	15	0.76±0.03	0.80±0.04	-0.741	0.471
联合治疗组	16	0.77±0.04	0.79±0.04	-0.688	0.502
F值 P值		0.063 0.939	0.082 0.921

组别	n	治疗前	治疗后	t值	P值
对照组	15	1.70±0.19	2.23±0.24	-3.366	0.005
EDP组	15	1.87±0.15	2.80±0.23	-5.415	< 0.001
联合治疗组	16	2.23±0.23	3.03±0.30	-4.883	< 0.001
F值 P值		1.971 0.152	2.467 0.097

Effect of external diaphragm pacing therapy combined with abdominal functional electrical stimulation on respiratory function for stroke patients

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组别	n	治疗前	治疗后	t值	P值
对照组	15	21.20±1.98	27.07±2.26	-3.454	0.004
EDP组	15	23.07±2.76	39.07±2.92^a	-10.328	< 0.001
联合治疗组	16	21.94±1.93	41.50±2.55^a	-10.838	< 0.001
F值 P值		0.172 0.843	8.844 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	15	26.47±2.63	38.27±3.44	-7.172	< 0.001
EDP组	15	28.60±2.45	45.20±3.73	-6.642	< 0.001
联合治疗组	16	34.63±3.33	50.75±4.71	-7.681	< 0.001
F值 P值		2.235 0.119	2.425 0.100

组别	n	治疗前	治疗后	t值	P值
对照组	15	1.32±0.06	1.53±0.08	-4.101	0.001
EDP组	16	1.34±0.10	1.90±0.09^a	-6.049	< 0.001
联合治疗组	17	1.36±0.08	1.92±0.15^a	-5.343	< 0.001
F值 P值		0.056 0.945	3.787 0.030

组别	n	治疗前	治疗后	t值	P值
对照组	15	0.18±0.01	0.19±0.01	-1.408	0.181
EDP组	16	0.17±0.01	0.18±0.01	-1.040	0.315
联合治疗组	17	0.19±0.01	0.21±0.01	-1.892	0.077
F值 P值		1.185 0.315	1.431 0.250

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