Abstract:

Objective  To investigate the effect of respiratory function training on respiratory function and conscious state of patients with severe cerebrovascular disease (SCVD).  Methods  A total of 27 patients with SCVD were divided into control group (N = 17) and observation group (N = 10). Control group received routine drug and rehabilitation treatment, and observation group was added respiratory function training based on routine treatment. The respiratory rate, tidal volume (TV), heart rate, blood pressure and artery oxygen saturation (SaO₂) of patients were monitored by breathing machine before and after 4-week treatment. Meanwhile, arterial blood gas analysis was used to detect arterial partial pressure of oxygen (PaO₂), oxygenation index, partial pressure of carbon dioxide (PaCO₂) and pH value. At the same time, Glasgow Coma Scale (GCS) was used to evaluate the conscious state of patients.  Results  All patients successfully completed 4-week rehabilitation training, without asphyxia, arrhythmia or other adverse events. Compared with before training, the respiratory rate (P = 0.006) and pH value (P = 0.010) were significantly decreased, while SaO₂ (P = 0.001), oxygenation index (P = 0.000) and GCS scores (P = 0.004, 0.017) were significantly increased in both groups of patients after training. There was no statistically significant difference between 2 groups on respiratory function indexes and GCS scores after training (P > 0.05, for all).  Conclusions  Respiratory function training did not significantly improve the respiratory function and conscious state of patients with SCVD, yet to be further studied. Randomized controlled clinical trials with larger, layered samples and long-term prognosis observation are needed. Examination method of respiratory function of SCVD patients is also a topic to be explored.

Key words: Stroke, Breathing exercises, Rehabilitation

摘要：

目的 探讨呼吸功能训练对重症脑血管病患者呼吸功能和意识状态的影响。 方法 共27 例重症脑血管病患者随机接受常规药物治疗和常规康复治疗（对照组，17 例）以及在此基础上联合呼吸功能训练（观察组，10 例），分别于训练前和训练4 周时呼吸机监测呼吸频率、潮气量、心率、血压和动脉血氧饱和度，动脉血气分析检测动脉血氧分压、氧合指数、二氧化碳分压和pH 值，Glasgow 昏迷量表（GCS）评价意识状态。 结果 27 例患者均顺利完成4 周的康复训练，无一例发生窒息、心律失常等不良事件。与训练前相比，训练后两组患者呼吸频率（P = 0.006）和pH 值（P = 0.010）降低，动脉血氧饱和度（P = 0.001）、氧合指数（P = 0.000）和GCS 评分（P = 0.004，0.017）升高；而训练后两组患者呼吸功能各项指标和GCS 评分差异均无统计学意义（P > 0.05）。 结论 呼吸功能训练并未显著改善重症脑血管病患者呼吸功能和意识状态，尚待扩大样本量、对样本进行分层、增加长期预后观察的随机对照临床试验的进一步研究，重症脑血管病患者呼吸功能监测方法也是今后探索的课题。

关键词: 卒中, 呼吸锻练, 康复