Discussion on the rehabilitation of pulmonary function in stroke patients
-
摘要: 近年来,脑卒中的发病率逐年升高,医院内脑卒中患者人数也持续上涨。急性脑卒中患者的心肺活动能力受限,长期卧床导致排痰功能下降,易引起肺水肿和肺部感染等并发症,对脑卒中患者的转归与康复产生极大阻碍。本文从发病机制对脑卒中相关性肺功能障碍进行了细致全貌分析,系统阐述了其康复治疗的难点,在此基础上优化了脑卒中患者肺功能康复的治疗方法,并对卒中后肺康复治疗的发展指明了方向。Abstract: In recent years, the incidence rate of stroke has generally enhancing, and the number of stroke patients in the hospital has constantly increasing. Occurrence of stroke dramatically reduces patients' physical activity as a result of motor function impairment accompanied by muscle weakening. Cerebral edema, autonomic nerve damage, neuro-humoral dysfunction, and low thorax activity, brought about by cerebral ischemia and cerebral hypoxia can of course lead to pulmonary infection and pneumonedema as well as other complications, which seriously affect the outcomes and prognosis of stroke patients. This article analyzes stroke-related pulmonary dysfunction, and discusses the difficulties of rehabilitation. On the basis of the difficulties, the authors puts forward rehabilitation measures of pulmonary function in patients with stroke, and gives suggestions on its future development.
-
Key words:
- pulmonary function /
- rehabilitation /
- stroke
-
[1] 陈方方, 胡 霞, 孔祥锋. 脑卒中相关性肺炎的危险因素及防治[J]. 临床肺科杂志, 2015, 23(5): 895-7 doi: 10.3969/j.issn.1009-6663.2015.05.038 [2] 梁利娜. 针刺康复疗法在脑卒中相关性肺炎治疗中的应用效果分析[J]. 中国当代医药, 2015, 23(1): 129-31 [3] 刘莹莹, 刘持善, 付秀丽, 等. 脑卒中相关性肺炎的危险因素及临床特点分析[J]. 山东医药, 2012, 52(20): 41-4 doi: 10.3969/j.issn.1002-266X.2012.20.015 [4] Polese JC, Pinheiro MB, Faria CD, et al. Strength of the respiratory and lower limb muscles and functional capacity in chronic stroke survivors with different physical activity levels[J]. Braz J Phys Ther, 2013, 17(5): 487-93 doi: 10.1590/S1413-35552012005000114 [5] Wong ES. Respiratory muscle dysfunction and training in chronic heart failure[J]. Heart Lung Circ, 2011, 20(5): 289-94 doi: 10.1016/j.hlc.2011.01.009 [6] 金 鑫, 赵 涵, 王俊芳, 等. β内啡肽对脑出血患者免疫系统功能的影响[J]. 中华医学杂志, 2003, 83(16): 1409-12 doi: 10.3760/j:issn:0376-2491.2003.16.011 [7] 关小凤. 脑卒中吞咽障碍的评价和康复训练[J]. 广西医科大学学报, 2004, 12(s1): 236-7 [8] 热那提. 探讨分析抗生素不合理应用和滥用对长期卧床脑卒中的感染危险及预防对策[J]. 中国保健营养, 2016, 26(15): 242-3 [9] 白姣姣, 卓明. 重型颅脑损伤并发肺炎的机制及护理(附30例临床体会)[J]. 中华现代护理学杂志, 2004, 10(4): 421-4 [10] 焦 莉. 脑卒中患者并发坠积性肺炎的护理体会[J]. 健康必读: 中旬刊, 2012, 20(9): 330-1 [11] 王 威, 陈路燕, 刘建平. 脑卒中后肺部感染的危险因素与预后[J]. 中华医院感染学杂志, 2007, 26(07): 805-6 doi: 10.3321/j.issn:1005-4529.2007.07.016 [12] 黄哲浩. 高血压性脑出血并发神经源性肺水肿的临床研究[D]. 吉林: 吉林大学. [13] 林 山. 颅脑损伤并发神经源性肺水肿的临床研究进展[J]. 大家健康: 中旬版, 2013, 7(4): 192-3 [14] Ambrosino N. Inspiratory muscle training in stable COPD patients: enough is enough[J]. Eur Respir J, 2018, 51(1): 36-9 [15] Mcdonald T, Stiller K. Inspiratory muscle training is feasible and safe for patients with acute spinal cord injury[J]. J Spinal Cord Med, 2018, 56(1): 1-8 doi: 10.1038/sc.2017.109 [16] Shei RJ, Chapman RF, Gruber AH. Inspiratory muscle training improves exercise capacity with thoracic load carriage[J]. Physiol Rep, 2018, 6(3): 312-9 [17] Wu JK, Fu L. Effects of inspiratory muscle training in chronic heart failure patients: a systematic review and meta-analysis[J]. Congenit Heart Dis, 2018, 49(2): 209-15 [18] Macko RF, Ivey FM, Forrester LW, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke - A randomized, controlled trial[J]. Stroke, 2005, 36(10): 2206-11 doi: 10.1161/01.STR.0000181076.91805.89 [19] 刘依凌, 白 玉, 孙姗姗, 等. 运动疗法对脑卒中患者血脂及生活质量的影响[J]. 中国疗养医学, 2009, (11): 1022-3 doi: 10.3969/j.issn.1005-619X.2009.11.052 [20] 朱永军. 运动疗法对冠心病患者血脂及生活质量的影响[J]. 中国临床康复, 2004, 8(24): 4972-3 doi: 10.3321/j.issn:1673-8225.2004.24.019 [21] 朱敬伟, 魏 强. 重度颅脑损伤后神经源性肺水肿的诊断和治疗[J]. 实用诊断与治疗杂志, 2007, 13(10): 793-4 doi: 10.3969/j.issn.1674-3474.2007.10.044 [22] Jo RM, Kim NS. Combined respiratory muscle training facilitates expiratory muscle activity in stroke patients[J]. J Phys Ther Sci, 2017, 29(11): 1970-3 doi: 10.1589/jpts.29.1970 [23] Kim JH, Yim J. Effects of respiratory muscle and endurance training using an individualized training device on the pulmonary function and exercise capacity in stroke patients[J]. Med Sci Monit, 2014, 20(5): 2543-9 [24] Main E. What is the best airway clearance technique in cystic fibrosis[J]. Paediatr Respir Rev, 2013, 14(Suppl 1): 10-2 [25] Nakazora T, Maeda J, Iwamoto K, et al. Intervention by speech therapists to promote oral intake of patients with acute stroke: a retrospective cohort study[J]. J Stroke Cerebrovasc Dis, 2017, 26(3): 480-7 doi: 10.1016/j.jstrokecerebrovasdis.2016.12.007 [26] Huang KL, Liu TY, Huang YC, et al. Functional outcome in acute stroke patients with oropharyngeal dysphagia after swallowing therapy[J]. J Stroke Cerebrovasc Dis, 2014, 23(10): 2547-53 doi: 10.1016/j.jstrokecerebrovasdis.2014.05.031 [27] Bulow M, Speyer R, Baijens L, et al. Neuromuscular electrical stimulation (NMES) in stroke patients with oral and pharyngeal dysfunction[J]. Dysphagia, 2008, 23(3): 302-9 doi: 10.1007/s00455-007-9145-9 [28] 马大亮, 刘艳丽. 盐酸氨溴索治疗急性脑卒中相关性肺炎的临床分析[J]. 中国医药指南, 1994, 32(1): 51-2 [29] 崔自芳. 机械通气联合氨溴索对老年脑卒中后重症肺炎的影响[J]. 中国实用神经疾病杂志, 2017, 34(15): 94-6 doi: 10.3969/j.issn.1673-5110.2017.15.031 [30] 王本才. 药物联合支气管镜肺泡灌洗治疗老年脑卒中并重度肺炎疗效观察[J]. 北方药学, 2017, 27(09): 57-9 doi: 10.3969/j.issn.1672-8351.2017.09.052 [31] Stoller O, de Bruin ED, Schindelholz MA, et al. Efficacy of Feedback-Controlled Robotics-Assisted treadmill exercise to improve cardiovascular fitness early after stroke: a randomized controlled pilot trial[J]. J Neurol Phys Ther, 2015, 39(3): 156-65 doi: 10.1097/NPT.0000000000000095 [32] Westendorp WF, Vermeij JD, Zock E, et al. The preventive antibiotics in stroke study (PASS): a pragmatic randomised open-label masked endpoint clinical trial[J]. Lancet, 2015, 385(9977): 1519-26 doi: 10.1016/S0140-6736(14)62456-9 [33] 方 平, 邢小丽, 于 帆, 等. 降低脑卒中吞咽障碍患者并发吸入性肺炎的护理研究[J]. 国际护理学杂志, 2012, 31(10): 1822-4 doi: 10.3760/cma.j.issn.1673-4351.2012.10.030 [34] 柯丽清. 优质护理在预防脑卒中患者并发坠积性肺炎的观察和护理[J]. 中外医学研究, 2017, 14(19): 82-3 [35] 霍金华. 预防脑卒中患者并发坠积性肺炎的护理观察[J]. 中国继续医学教育, 2015, 28(21): 241-2 doi: 10.3969/j.issn.1674-9308.2015.21.179
点击查看大图
计量
- 文章访问数: 1310
- HTML全文浏览量: 430
- PDF下载量: 37
- 被引次数: 0