Effect Of Pulmonary Function Trainer On Improving Respiratory Function In Patients With Tracheotomy After Cervical Spinal Cord Injury

Objective: Through randomized controlled studies to analyze the clinical data of two groups of patients treated with pulmonary function trainer on the basis of conventional respiratory rehabilitation treatment and conventional respiratory rehabilitation,compare and analyze the general data and pathological data of the two groups,and the clinical data of lung function and ultrasound diaphragm before and after treatment,we will explore whether the pulmonary function trainer has a clear effect on the respiratory function rehabilitation of tracheostomy patients after CSCI,and provide clinical reference for clinical rehabilitation physicians in the selection of respiratory rehabilitation treatment methods for patients.Method: According to the specified enrollment and exclusion criteria,patients hospitalized in the Rehabilitation Medicine Department of Jiangsu Subei People’s Hospital from April 2021 to May 2022 after tracheostomy after cervical spinal cord injury were selected as research subjects,and were divided into treatment group and control group according to the random number table method.The treatment group was treated with conventional rehabilitation training + pulmonary function trainer.The control group received routine rehabilitation training.The general data of the two groups were compared and analyzed,and the pulmonary function assessment,ultrasound diaphragm assessment,cough reflex score,extubation time,and ADL score before and after treatment were analyzed.Statistical Methods: Software: Data analysis using SPSS version 26.0;Analysis method: Use t-test analysis to process measurement data that conform to normal distribution,and use rank sum test analysis to process measurement data that do not conform to normal distribution.The χ2 test was used to analyze the counting data of the grade data,and the rank sum test was used to analyze the counting data of the non-grade data.Results: P<0.05 indicates a statistical difference.Results: Of the 41 patients included in the analysis,21 patients were treated with conventional rehabilitation + pulmonary function trainer,assigned to the treatment group,and 20 patients were assigned to the control group with conventional rehabilitation treatment,there were no statistical differences in the general clinical data between the two groups.The patients in the two groups were comparable.There were no significant differences in cervical spinal cord injury segment,ASIA grade,and injury time between the two groups.In the results of pulmonary function assessment,there was no significant difference between the data results before treatment between the two groups,and there was no significant difference in MEP,FEV1 and TLC after treatment.There were statistical differences in MIP,VC and MVV,P<0.001,P=0.033 and P=0.015,respectively;the MIP,VC and MVV in the post-treatment group were 79.9±9.7cmH2 O,0.4±0.1L,67.5±10.1L/min,respectively,which were significantly higher than66.0±7.1cm H2 O,0.3±0.1L,59.9±9.2L/min of the control group.Among the results of ultrasound diaphragm evaluation,and there was no statistical difference between the two groups before the treatment,and there were statistical differences in the data results of DE and DTF after treatment,P<0.05,respectively;After one course of treatment,DE and DTF in the treatment group were 6.8±0.9mm and 0.6±0.1,respectively,which were significantly higher than those of 5.9±1.6mm and 0.4±0.1 in the control group;the time data of tracheal cannula removal in the treatment group and the control group did not conform to the normal distribution,so the rank sum test was used,Z=-2.876,P<0.05,there were statistical differences between the two groups.The mean extubation time of the treatment group was 11.3d,and the median was 11 days,which was lower than that of the control group of 15.7 days and the median was 16 days;the data of the two groups were not statistically significant in cough reflex score,extubation rate and daily living ability score.Conclusion: Through the comparative analysis of the two sets of clinical statistics,the following conclusions were drawn: 1.The application of pulmonary function trainer on the basis of conventional rehabilitation treatment can significantly improve the pulmonary ventilation function and diaphragm motor function of tracheostomy patients after cervical spinal cord injury,and help the recovery of patients’ respiratory function;2.The application of pulmonary function trainer on the basis of routine rehabilitation can effectively reduce the time consumed from admission to removal of the tracheal cannula.3.The treatment group using pulmonary function trainer has comparable efficacy to the control group in coughing ability and daily living ability,and the long-term efficacy needs to be confirmed by further research.