摘要
目的探讨不同强度吸气肌训练对重症患者肺功能、住院时间及生活质量的影响。方法纳入2023年1月—2023年6月南部战区总医院重症监护病房、高依赖病房、心脏外科监护室的患者共42例,随机分为对照组14例、低强度吸气肌训练组14例及中等强度吸气肌训练组14例。对照组采用常规治疗,低强度吸气肌训练组患者在常规治疗基础上加用20%的最大吸气压(maximum inspiratory pressure,MIP)作为起始阈值负荷进行吸气肌训练,中等强度吸气肌训练组患者在常规治疗基础上加用40%的MIP作为起始阈值负荷行吸气肌训练。训练6周后评估MIP、用力肺活量、膈肌厚度及移动度、住院时间和生活质量。结果共40例患者完成训练,三组患者MIP差异有统计学意义(P<0.05),用力肺活量差异有统计学意义(P<0.05)。膈肌厚度差异无统计学意义(P=0.566),对照组膈肌移动度低于低强度吸气肌训练组(P=0.021),低强度吸气肌训练组与中等强度吸气肌训练组间也存在差异(P=0.036)。三组患者在监护室中的住院时间存在差异(P=0.034),对照组与低强度吸气肌训练组间差异无统计学意义(P=0.149),但中等强度吸气肌训练组住院时间较对照组显著缩短(P=0.016)。中等强度的吸气肌训练与对照组、低强度吸气肌训练组相比可以明显提升患者的生活质量(P<0.05)。结论低强度的吸气肌训练和中等强度吸气肌训练均可以提升重症患者的肺功能,改善患者的膈肌移动度,促进患者肺康复。中等强度吸气肌训练对患者肺功能的改善效果明显优于低强度吸气肌训练。并且中等强度的吸气肌训练可能对提升患者的生活质量,缩短患者住院时间有更明显的效果。
Objective To explore the effects of different intensity of inspiratory muscle training on pulmonary function,hospitalisation time and quality of life of critically ill patients.Methods A total of 42 patients were included in the intensive care ward,high dependency ward,and cardiac surgery ward of the Southern Theatre General Hospital from January 2023 to June 2023,and were randomly divided into 14 cases in the control group,14 cases in the low-intensity inspiratory muscle training group,and 14 cases in the moderate-intensity inspiratory muscle training group;conventional treatment was used for the control group,and 20%of the maximum inspiratory pressure(MIP)was added as the starting threshold load for inspiratory muscle training for the patients of the low-intensity inspiratory muscle training group on the basis of conventional treatment.In the control group,conventional treatment was used;in the low-intensity inspiratory muscle training group,20%of the maximum inspiratory pressure(MIP)was added to the conventional treatment as the starting threshold load for inspiratory muscle training;in the medium-intensity inspiratory muscle training group,40%of the MIP was added to the conventional treatment as the starting threshold load for inspiratory muscle training;and the maximal inspiratory pressure,exertional lung capacity,diaphragm thickness and mobility,hospital stay and quality of life were evaluated after 6 weeks of training.Results A total of 40 patients completed the training,and the three groups showed statistically significant differences in MIP(P<0.05)and statistically significant differences in exertional lung capacity(P<0.05).There was no statistically significant difference in diaphragm thickness(P=0.566),and diaphragm mobility was lower in the control group than in the low-intensity inspiratory muscle training group(P=0.021),and there was also a difference between the low-intensity inspiratory muscle training group and the moderate-intensity inspiratory muscle training group(P=0.036);there was a difference in the length of stay in the care unit among the three groups(P=0.034),and there was no statistically different(P=0.149),and the duration of hospital stay was significantly shorter in the moderate intensity inspiratory muscle training group compared to the control group(P=0.016).Medium-intensity inspiratory muscle training can significantly improve patients'quality of life compared with the control group and low-intensity inspiratory muscle training group(P<0.05).Conclusions Both low-intensity inspiratory muscle training and moderate-intensity inspiratory muscle training can enhance the lung function of critically ill patients,improve their diaphragm mobility,and promote their pulmonary rehabilitation.Medium-intensity inspiratory muscle training was significantly better than low-intensity inspiratory muscle training in improving the lung function of patients.Moreover,moderate-intensity inspiratory muscle training may have positive significance in improving patients'quality of life and shortening their hospitalisation time.
作者
豆艺璇
黄怀
何莲
邢然然
钱绮雯
程天豪
白建芳
DOU Yixuan;HUANG Huai;HE Lian;XING Ranran;QIAN Qiwen;CHENG Tianhao;Bai Jianfang(Graduate School of Guangzhou University of Traditional Chinese Medicine,Guangzhou,Guangdong 510006,P.R.China;Department of Rehabilitation,Critical Care Rehabilitation Centre,General Hospital of the Southern Theatre of the Chinese People’s Liberation Army,Guangzhou,Guangdong 510010,P.R.China;Graduate School of Guangdong Pharmaceutical University,Guangzhou,Guangdong 510006,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2023年第10期702-709,共8页
Chinese Journal of Respiratory and Critical Care Medicine
基金
军队后勤科研项目(CLB20J034)
关键词
吸气肌训练
重症患者
肺功能
康复
Inspiratory muscle training
critically ill patients
pulmonary function
rehabilitation
作者简介
通信作者:黄怀,Email:haunghuai1999@sina.com
