目的 探讨电针联合膈肌起搏器对卒中后呼吸功能障碍患者肺功能、膈肌功能和日常生活能力的影响。方法 选取医院于2021年1月—2022年12月间收治的卒中患者中出现呼吸功能障碍者共154例，根据治疗方法不同将其分为观察组(79例)和对照组(75例)，其中对照组给予膈肌起搏器治疗，观察组在对照组的治疗基础上给予电针治疗。两组患者治疗4周后，观察患者治疗前后的用力肺活量(forced vital capacity，FVC)、每分钟最大自主通气量(maximal volun-tary ventilation，MVV)、第 1 秒用力呼气容积(forced expiratory volume in one second，FEV1)、动脉血氧分压(partial pressure of oxygen in arterial blood，PaO2)、二氧化碳分压(arterial partial pressure of carbon dioxide，PaCO2)、脑肌运动幅度、脑肌电位(electrical activity of diaphragm，EAdi)峰值以及 Barthel 指数(Barthel index，BI)的变化。结果 治疗后，两组的FVC、MVV及FEV1均升高，且观察组的各项水平均高于对照组(P＜0。05)。两组的Pa02均升高，且观察组的水平高于对照组(P＜0。05);两组的PaCO2均降低，且观察组的水平低于对照组(P＜0。05)。观察组的膈肌运动幅度增加(P＜0。05)，对照组的膈肌运动幅度变化不明显(P＞0。05)，观察组的运动幅度高于对照组(P＜0。05)。两组的EAdi峰值均上升，且观察组的水平高于对照组(P＜0。05)。两组的BI均上升，且观察组的水平高于对照组(P＜0。05)。结论 电针联合膈肌起搏器可改善卒中后呼吸功能障碍患者的肺功能和膈肌功能，有效提高患者的日常生活能力。
Effect of Electroacupuncture Combined with External Diaphragm Pacemaker on Pulmonary Function,Diaphragm Function and Activities of Daily Living in Patients with Post-Stroke Respiratory Dysfunction
Objective To explore the effect of electroacupuncture combined with external diaphragm pacemaker on pulmonary function,diaphragm function and activities of daily living in patients with post-stroke respiratory dysfunction.Methods One hun-dred and fifty-four patients with post-stroke respiratory dysfunction in the hospital from January 2019 to December 2022 were enrolled,and assigned into two groups according to different treatment methods.The control group(75 cases)received external diaphragm pacemaker,while the observation group(75 cases)received electroacupuncture combined with external diaphragm pacemaker.Then the forced vital capacity(FVC),maximum voluntary ventilation(MVV),forced expiratory volume in the first second(FEV1),partial pressure of oxygen in arterial blood(PaO2),arterial partial pressure of carbon dioxide(PaCO2),diaphrag-matic amplitude,peak value of electrical activity of the diaphragm(EAdi)and Barthel index(BI)were observed in both groups at the baseline and 4 weeks of treatment.Results After treatment,the values of FVC,MVV and FEV1 increased in both groups,and the increase was more remarkable in the observation group than that in the control group(P＜0.05).An increase in PaO2 and a decrease in PaCO2 were observed in both groups,and both changes were more notable in the observation group than those in the control group(P＜0.05).The diaphragmatic amplitude showed an increase in the observation group(P＜0.05),while there was no obvious change in the control group after treatment(P＞0.05),so the post-treatment diaphragmatic amplitude of the observa-tion group was larger than that of the control group(P＜0.05).The peak value of EAdi increased in both groups after treatment,and was higher in the observation group than that in the control group(P＜0.05).BI score elevated in both groups after treat-ment,and the observation group scored higher on BI than the control group(P＜0.05).Conclusion The application of electroacu-puncture combined with external diaphragm pacemaker in patients with post-stroke respiratory dysfunction can effectively im-prove the pulmonary function,diaphragm function and activities of daily living.
post-stroke periodrespiratory dysfunctionelectroacupunctureexternal diaphragm pacemakerpulmonary func-tiondiaphragm functionactivities of daily living
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