感觉再训练及口服弥可保在周围神经损伤患者感觉功能恢复中的作用

Effect of sensory reeducation in combination with methycobal on sensory restoration of peripheral nerve injury

目的探讨感觉再训练及口服弥可保片剂对周围神经修复术后患者感觉功能恢复的促进作用。方法共收集急诊腕部正中神经或尺神经切割离断伤患者92例,经神经修复术后将其随机分为4组,联合组给予感觉再训练及口服弥可保(甲基维生素B12)片剂治疗;训练组给予单纯感觉再训练治疗;弥可保组则给予单纯口服弥可保片剂治疗;对照组未给予感觉再训练及口服弥可保片剂治疗。以术后第1年及第2年随访得到的感觉功能分级及动态两点辨别觉作为疗效评测指标。结果术后第1年及第2年时,联合组、训练组及弥可保组上述各检测指标均优于对照组(P均<0.05);术后第1年时,联合组疗效优于弥可保组与训练组(P<0.05),且弥可保组与训练组之间差异无统计学意义(P>0.05);术后第2年时,联合组与训练组疗效均优于弥可保组(P<0.05),且联合组与训练组之间的差异无统计学意义(P>0.05)。结论感觉再训练或口服弥可保片剂均能显著促进周围神经损伤患者感觉功能的恢复,如将两者早期联用则疗效更佳。

Objective To explore the effect of sensory reeducation and methycobal on sensory restoration after repair of peripheral nerve. Methods Ninety-two patients with median or ulnar nerve injuries in the wrist were divided randomly into 4 groups. Combined treatment group were treated with sensory reeducation and oral intake of methycobal; Reeducation treatment group were treated with sensory reeducation; methycobal treatment group were treated with oral intake of methycobal ; Control group were not treated with sensory reeducation or oral intake of methycobal. Sensation level and moving two-point discrimination（m2-PD） of fingers were examined at the end of the 1st and 2nd year postoperation. Results Both results examined in the combined treatment group, reeducation treatment group and methycobal treatment group were all superior to those in the control group at the end of the 1st and 2nd year postoperation. At the end of the 1st year postoperation, combined treatment group were superior to reeducation treatment group and methycobal treatment group, but there was no difference between reeducation treatment group and methycobal treatment group. At the end of the 2nd year, both combined treatment group and reeducation treatment group was superior to methycobal treatment group, but there was no difference between combined treatment group and reeducation treatment group. Conclusion It was demonstrated that sensory reeducation and methycobal could all significantly promote sensory restoration and the effect was more significant when treated early with both sensory reeducation and methycobal.