脑卒中患者腹肌增厚率对肺通气功能的作用效果分析

关键词：脑卒中  腹肌  膈肌  肺通气

Keywords:stroke  abdominal muscles  diaphragm  pulmonary ventilation

摘要：

      摘要 目的：探讨脑卒中患者腹肌增厚率对肺通气功能的影响，为脑卒中呼吸康复治疗方案优化提供依据。 方法：选取2022年9月—2023年2月在山东中医药大学附属医院康复科住院脑卒中患者75例，同时选取健康体检者30例作为对照组。采用肺功能检测仪评估患者的通气功能（FVC、FEV1、MVV、PEF和MEF50），采用B超测量腹内斜肌、腹外斜肌、腹横肌增厚率及膈肌移动度。分析腹肌增厚率、膈肌移动度与肺通气功能指标的相关性。 结果：脑卒中患者在腹内斜肌、腹横肌及腹外斜肌用力状态下的厚度均显著低于健康人群（P<0.05）。相关性分析结果显示，腹内斜肌增厚率、膈肌移动度与FVC、FEV1、PEF、MEF50间均具有显著正相关；腹横肌增厚率和腹外斜肌增厚率与FVC、FEV1、MVV、PEF、MEF50指标间呈现显著正相关（P<0.05）。一般线性回归分析结果显示，腹横肌增长率和腹内斜肌增长率是FVC的独立影响因素，同时腹横肌增长率也是FEV1、MVV、PEF、MEF50的独立影响因素，均具有显著性意义（P<0.05）。 结论：腹肌增厚率是影响脑卒中患者肺通气功能的独立影响因素。在脑卒中呼吸康复治疗过程中，除加强膈肌训练外，应高度重视腹肌肌力的训练以进一步改善患者肺功能。

Abstract:

      Abstract Objective： To explore the effect of abdominal muscle thickening rate on pulmonary ventilation function in stroke patients，and to provide evidence for respiratory rehabilitation treatment of stroke. Method： Eighty-nine stroke patients hospitalized in the Rehabilitation Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine， from September 2022 to February 2023，were enrolled. Pulmonary function detector was used to assess the respiratory function of patients，and B-ultrasound was used to measure the thickening rate of abdominal internal oblique muscle，abdominal external oblique muscle，transverse muscle of abdomen and the mobility of diaphragm.Correlations between abdominal muscle thickening rate， diaphragm mobility， and lung ventilation function indicators were analyzed by SPSS19.0 software. Result： The thickness of internal oblique muscle， transverse abdominal muscle and external oblique muscle in stroke patients was significantly lower than that in healthy people （P<0.05）. Correlation analysis showed a significant positive correlation between the thickening rate of abdominal internal oblique muscle and FVC， FEV1， PEF， MEF50. The thickening rates of transverse abdominal muscle and abdominal external oblique muscle were significantly positively correlated with the six indexes（P<0.05）. General linear regression analysis showed that the growth rates of transverse abdominal muscle and abdominal internal oblique muscle were the independent influencing factors for FVC， and the growth rate of transverse abdominal muscle was the independent influencing factors for FEV1， MVV， PEF， MEF50 （P<0.05）. Conclusion： Abdominal muscles are an important factor affecting respiratory function in stroke patients. Therefore，it is necessary to strengthen expiratory muscle training except for strengthening diaphragm training. And more attention should be paid to abdominal muscle strength training to further improve patient lung function in these patients.