系统性呼吸训练对颈髓损伤患者膈肌运动及肺功能的影响

目的：探讨系统性呼吸训练对颈髓损伤患者膈肌运动及肺功能的影响。方法：将60例颈髓损伤患者随机分为观察组和对照组，每组各30例。对照组给予常规的康复训练和健康宣教，观察组在常规康复的基础上增加系统性呼吸训练，观察周期为6周，对比2组患者的肺功能指标、膈肌运动幅度及呼吸困难程度。结果：治疗6周后，2组患者的用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、峰值呼气流速（PEF）、每分钟最大通气量（MVV）及膈肌运动幅度均较治疗前有明显提高（P<0.01）；且观察组的FVC、FEV1、PEF、MVV值及膈肌运动幅度均显著优于对照组（P<0.05）。2组患者的Brog呼吸困难评分从第3周均较第1周明显降低（P＜0.05），且从第4周开始，观察组较对照组降低更明显（P＜0.05）。结论：系统性呼吸训练联合常规康复训练可以有效改善颈髓损伤患者的膈肌运动及肺功能，在临床工作中应重视呼吸功能训练。

Effects of systemic respiratory training on diaphragm movement and pulmonary function in patients with cervical spinal cord injury

Objective: To investigate the effect of systemic respiratory training on diaphragm movement and pulmonary function in patients with cervical spinal cord injury (SCI). Methods: A total of 60 patients with cervical SCI were randomly divided into experimental group (n=30) and control group (n=30). The control group was given routine rehabilitation training and health education (40 min each time, once a day, 5 times a week for 6 weeks), while the experimental group was given systemic respiratory training (40 min each time, once a day, 5 times a week for 6 weeks) on the basis of routine rehabilitation training. The observation period was 6 weeks. Independent sample t-test was used to compare the indexes of pulmonary function, diaphragm motion amplitude and degree of dyspnea between the two groups. Results:Before treatment, there was no significant difference in all evaluation indexes between the two groups, but after 6 weeks of treatment, the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF), maximum ventilation per minute (MVV) and diaphragm movement amplitude were significantly improved in the two groups (P<0.01). The FVC, FEV1, PEF, MVV and diaphragm motion amplitude in the experimental group were significantly improved as compared with those in the control group. The Brog dyspnea score of the two groups decreased significantly from the 3rd week to the 1st week, and from the 4th week, the decrease in the experimental group was more significant than that in the control group (P<0.05). Conclusion: Regular and scientific respiratory training combined with routine rehabilitation training can effectively improve diaphragm movement and pulmonary function in patients with cervical SCI. Respiratory function training should be paid attention to in clinical work.