| Objective:Respectively collect the relevant data,consisting of community-acquired pneumonia CURB-65 score,pneumonia severity index(PSI)and National Institute of Health stroke scale(NIHSS),of patients with severe hemorrhagic stroke-associated pneumonia(SAP),who were treated with early comprehen-sive pulmonary rehabilitation,when the treatment lasted for 7 days,14 days,21 days and even before the treatment.Those data is in contrast to historical cases to evaluate and discuss the therapeutic effect of early comprehensive pulmonary rehabilitation on severe hemorrhagic stroke-associated pneumonia and the recovery of brain function.Methods:The control group: 60 patients with severe hemorrhagic stroke-associated pneumonia admitted to the neurosurgery departments of our hospital met the inclusion criteria from June 2018 to September 2019.The experimental group:57 patients with severe hemorrhagic stroke-associated pneumonia who met the inclusion criteria were admitted to our hospital from October 2019 to December 2020,and they signed the informed consent.The two groups formed a historical control.The control group received traditional basic pulmonary rehabilitation and clinical symptomatic treatment(fighting infection,atomization,expectorant).The experimental group was treated with early comprehensive pulmonary rehabilitation on the basis of the control group,including diaphragmatic electrical stimulation,swallowing training,cough training and respiratory training.A total of 57 patients in the experimental group were enrolled,of whom 1 was excluded due to rebleeding,1 were excluded due to respiratory failure for mechanical ventilation,2 were excluded due to concurrent atrial fibrillation,and 2 were excluded during spontaneous withdrawal.While when the control group was in the course of traditional pulmonary rehabilitation treatment,2 was excluded due to rebleeding,1 were excluded due to respiratory failure for mechanical ventilation,2 were excluded due to concurrent atrial fibrillation.A total of 106 cases were finally collected,including 51 cases in the experimental group and 55 cases in the control group.All patients were evaluated by CPIS score and PSI score to evaluate the treatment effect of stroke-associated pneumonia,by NIHSS score to evaluate the recovery of brain function.And then correlation statistical analysis was performed.Results:1.There was no significant difference in the basic data(age,gender,smoking,hypertension,diabetes,hemorrhaging location)analysis between the experimental group and the control group,and the two groups were comparable(P>0.05).2.Before the treatment,the CURB-65 score was 3.730±0.75 in the experimental group while 3.980±0.733 in the control group.And the PSI score was 142.670±12.346 in the experimental group while 143.380±12.146 in the control group.When the treatment lasted for 7 days,the CURB-65 score was2.450±0.642 in the experimental group while 3.870±0.668 in the control group,and the PSI score was 118.180±12.031 in the experimental group while130.290±11.888 in the control group.When the treatment lasted for 14 days,the CURB-65 score was 1.370±0.488 in the experimental group while2.780±0.599 in the control group,and the PSI score was 118.180±12.031 in the experimental group while 130.290±11.888 in the control group.When the treatment lasted for 21 days,the CURB-65 score was 1.370±0.488 in the experimental group while 1.350±0.48 in the control group,and the PSI score was 87.960±10.17 in the experimental group while 86.650±10.184 in the control group.Intra-group comparison shows that CURB-65 score and PSI score in both groups were decreased with the increase of time.The difference was statistically significant(P < 0.05).It Suggests that after treatment,the pneumonia in both groups was better than before.Comparison between groups showed that before treatment,there was no statistical difference in the pneumonia status between the two groups(P < 0.05),the two groups were comparable(P > 0.05).There was a statistically significant difference in pneumonia status between 7 and 14 days after treatment,and CURB-65 score and PSI score were significantly lower in the experimental group than in the control group.It suggested that the therapeutic effect of the experimental group was better than the control group.There was no statistically significant difference in pneumonia status at 21 days after treatment(P<0.05).It Suggests that after treatment,eventually,the pneumonia tends to be curable.After repeated measurement analysis of variance,Interaction effect of Curb score and PSI score in 2 groups(P<0.05).It is suggested that the therapeutic effect of the two rehabilitation methods varies with time.By Fig.3 and Fig.4 know,the therapeutic effect of the experimental group changed more obviously after the same time.It suggested that the therapeutic effect of the experimental group was better than the control group.3.Before the treatment,the NIHSS score was 27.650±5.396 in the experimental group while 29.360±4.432 in the control group.When the treatment lasted for 7 days,the NIHSS score was 25.820±5.451 in the experimental group while 27.490±4.438 in the control group.When the treatment lasted for 14 days,the NIHSS score was 22.370±4.882 in the experimental group while 25.850±4.218 in the control group.When the treatment lasted for 21 days,the NIHSS score was 17.390±4.02 in the experimental group while 22.440±4.059 in the control group.Intragroup comparison shows that NIHSS score in both groups were decreased with the increase of time.The difference was statistically significant(P < 0.05).It suggests that after treatment,the recovery of brain function in both groups was better than before.Comparison between groups showed that before treatment,there was no significant difference in the degree of brain function deficit between the two groups(P < 0.05),the two groups were comparable(P >0.05).There was no statistical difference in the degree of recovery of brain function 7 days after treatment(P > 0.05).This indicates that the recovery process of brain function is slow.The change is not obvious in a short period of time.There was a statistically significant difference in brain function recovery status between 14 and 21 days after treatment(P < 0.05)and NIHSS score were significantly lower in the experimental group than in the control group.It suggested that the therapeutic effect of the experimental group was better than the control group.After repeated measurement analysis of variance,interaction effect of NIHSS score in 2 groups P<0.05.It is suggested that the therapeutic effect of the two rehabilitation methods varies with time.By Fig.5know,the therapeutic effect of the experimental group changed more obviously after the same time.It suggested that the therapeutic effect of the experimental group was better than the control group.Conclusion:Early comprehensive pulmonary rehabilitation therapy for patients with severe hemorrhagic stroke-associated pneumonia can promote the rapid recovery of pneumonia and promote the early recovery of brain function.The effect is significantly better than traditional treatment,and it is a more effective,more reasonable and more meaningful treatment. |
PDF Full Text Request