Liao Zhanjun, Liao Feiwei
Zhanjun Liao, Rehabilitation Medicine Department, Liuzhou People's Hospital, Liuzhou, Guangxi, China.
Feiwei Liao, Rehabilitation Medicine Department, Liuzhou People's Hospital, Liuzhou, Guangxi, China.
Pak J Med Sci. 2024 Aug;40(7):1545-1550. doi: 10.12669/pjms.40.7.8113.
This study aimed to evaluate the clinical effectiveness of early pulmonary rehabilitation (PR) treatment methods for stroke-associated pneumonia (SAP).
This is a prospective, randomized controlled intervention study. Eighty SAP patients admitted to the rehabilitation department of Liuzhou People's Hospital from June 2020 to December 2021 were selected and divided into an intervention group (40 cases) and a control group (40 cases) using the random number table approach. Patients in both groups received conventional treatments. Patients in the intervention group received early PR interventions, while patients in the control group received conventional rehabilitation treatment. The clinical effectiveness and pulmonary function indexes were compared.
The intervention group showed shorter durations of stay in the intensive care unit, relief from symptoms, and mechanical ventilation compared to the control group following treatment (P < 0.05). The total clinical efficacy after intervention in the treatment group was 82.50%, significantly higher than the control group's rate of 47.50% (P < 0.05). After 21 days of treatment, the forced expiratory volume in one second (FEV1)/predicted value in the intervention group was 64.92 ± 8.53, while it was 52.69 ± 7.08 in the other group. The FEV1/forced vital capacity in the intervention group was 59.73 ± 7.18, compared to 50.36 ± 6.54 in the control group. The intervention group had a clinical pulmonary infection score of 2.62 ± 1.13, while the control group had a score of 4.17 ± 2.08. The intervention group showed a significant improvement in lung function, with statistically significant differences compared to the other group (P < 0.05). Moreover, the intervention group had significantly lower levels of interleukin-4 and interleukin-10 compared to the control group, with statistical significance (P < 0.05). The average National Institute of Health Stroke Scale score of the intervention group was significantly lower than that of the control group in the second and third weeks after treatment (P < 0.05).
Early comprehensive pulmonary rehabilitation can significantly enhance the pulmonary function and respiratory status of SAP patients and facilitate the early recovery of brain function. This approach archives significantly better outcomes compared to conventional PR; therefore, it is worth clinical implementation.
本研究旨在评估早期肺康复（PR）治疗方法对卒中相关性肺炎（SAP）的临床疗效。
这是一项前瞻性、随机对照干预研究。选取2020年6月至2021年12月在柳州市人民医院康复科住院的80例SAP患者，采用随机数字表法分为干预组（40例）和对照组（40例）。两组患者均接受常规治疗。干预组患者接受早期PR干预，对照组患者接受常规康复治疗。比较两组的临床疗效和肺功能指标。
治疗后，干预组在重症监护病房的住院时间、症状缓解情况及机械通气时间均短于对照组（P<0.05）。治疗组干预后的总临床有效率为82.50%，显著高于对照组的47.50%（P<0.05）。治疗21天后，干预组一秒用力呼气容积（FEV1）/预计值为64.92±8.53，对照组为52.69±7.08。干预组FEV1/用力肺活量为59.73±7.18，对照组为50.36±6.54。干预组临床肺部感染评分为2.62±1.13，对照组为4.17±2.08。干预组肺功能明显改善，与对照组比较差异有统计学意义（P<0.05）。此外，干预组白细胞介素-4和白细胞介素-10水平明显低于对照组，差异有统计学意义（P<0.05）。治疗后第二周和第三周，干预组美国国立卫生研究院卒中量表平均评分明显低于对照组（P<0.05）。
早期综合肺康复可显著改善SAP患者的肺功能和呼吸状况，促进脑功能早期恢复。与传统PR相比，该方法疗效显著，值得临床推广应用。
