高压氧结合偏瘫手佩戴手功能位保持枕干预对脑损伤后偏瘫患者疗效及运动功能的影响

Effects of hyperbaric oxygen combined with the intervention of functional position keeping pillow for the hemiplegic hand on the efficacy and motor function of hemiplegic patients after brain injury

目的研究高压氧(hyperbaric oxygen,HBO)结合偏瘫手佩戴手功能位保持枕干预对脑损伤后偏瘫患者的临床疗效及对运动功能的影响。方法以海安市人民医院2017年1月至2020年1月收治的90例脑损伤后偏瘫患者作为研究对象,按照随机数字表法分为观察组和对照组,每组45例。2组患者均采取偏瘫手佩戴手功能位保持枕干预,观察组在此基础上联合HBO治疗,所有患者均治疗2个月。采用Brunnstrom手功能量表评分及Barthel指数评价手功能,采用视觉模拟量表(visual analogue scale,VAS)评分评估疼痛情况,采用本院自行设计的手部护理(压疮、清洁、潮湿、气味)评分量表评估手部护理情况,通过创伤后成长评定量表(posttraumatic growth inventory,PTGI)评分、抗逆力水平量表(connor-davidson resilience scale,CD-RISC)中文版评分评估康复依从性。结果2组患者经过治疗后,Brunnstrom评分以及Barthel指数均显著升高,且观察组显著高于对照组(P<0.05);VAS评分均显著下降,且观察组显著低于对照组(P<0.05);观察组患者的压疮、清洁、潮湿、气味评分以及肿胀程度均显著低于对照组(P<0.05);2组患者的PTGI、CD-RISC评分均显著升高,且观察组患者显著高于对照组(P<0.05)。结论脑损伤后偏瘫患者采用HBO结合偏瘫手佩戴手功能位保持枕干预,疗效良好,可有效改善患者的运动功能。

Objective To study the effects of hyperbaric oxygen(HBO)combined with the intervention of functional position keeping pillow for the hemiplegic hand on the efficacy and motor function of hemiplegic patients after brain injury.Methods A total of 90 patients with hemiplegia after brain injury treated in Hai’an People’s Hospital from January 2017 to January 2020 were selected as the research subjects and divided into observation group and control group according to the random number table method,with 45 cases in each group.Both groups were given the intervention of functional position keeping pillow for the hemiplegic hand.The observation group was additionally treated with HBO.All patients received two-month treatment.The hand function was evaluated by the Brunnstrom Hand Function Scale and Barthel Index.The severity of pain was evaluated by the visual analogue scale(VAS).The conditions of hand care were evaluated by the hand care scale(including pressure sores,cleanliness,moisture,odor)designed by Hai’an People’s Hospital.The rehabilitation compliance was evaluated by the Posttraumatic Growth Inventory(PTGI)score and the Chinese version of the Connor-Davidson Resilience Scale(CD-RISC).Results After treatment,the scores of Brunnstrom Hand Function Scale and Barthel Index of the two groups were significantly increased,and the scores of the observation group were significantly higher than those of the control group(P<0.05);the VAS scores of the two groups were significantly decreased,and the scores of the observation group were significantly lower than those of the control group(P<0.05);in terms of pressure sores,cleanliness,moisture,odor,and swelling degree,the scores of the observation group were significantly lower than those in the control group(P<0.05);the scores of PTGI and CD-RISC of the two groups were significantly increased,and the scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion After brain injury,hyperbaric oxygen combined with the intervention of functional position keeping pillow for the hemiplegic hand can significantly improve the motor function of patients.