神经性瘫痪患者抗骨质疏松抗挛缩研究

Study of anti-osteoporosis and anti-contracture in patients with neurogenic paralysis

目的探讨治疗和预防神经性瘫痪患者的骨质疏松症和关节挛缩的临床康复方法和理论，寻求抗骨质疏松抗挛缩的新途径。方法先后对两组各３０例神经性瘫痪患者分别进行运动功能评价、骨密度测定及血钙血磷等生化测定，并用生物力学疗法进行康复治疗。结果两组神经性瘫痪患者骨密度均低于正常人。验证抗挛缩、抗骨疏松疗效，可用关节活动范围和徒手肌力检查进行评价。寻求到该评价法和生物力学疗法在抗骨质疏松和抗关节挛缩与骨密度及血钙、血磷等生化测定检验结果间的理化关系式。结论神经性瘫痪患者因失应力和钙丢失而造成骨质疏松和关节挛缩。抗关节挛缩是抗骨质疏松的关键；应尽早实行物理康复。

Objective To assess the methods and theory of treatment and prevention, and to search the new effective approach of antiosteoporosis, anticontracture and clinicophysical rehabilitation in patients with neurogenic paralysis. Method Sixty patients with neurogenic paralysis were divided into two groups (30 in each), their kinetic function was evaluated, bone mineral density (BMD), serum levels of calcium and phosphorus were determined. The abilities of anticontracture and antiosteoporotic fracture were evaluated with the parameters of joint moving range and muscular strength. Results BMD in patients with neurogenic paralysis in both groups is significantly lower than that in normal control. The abilities of anticontracture and antiosteoporotic fracture were closely correlated with BMD, serum levels of calcium and phosphorus. Conclusion Osteoporosis and contracture in patients with neurogenic paralysis may be induced by stress and calcium loss. A theory of higravity was proposed. Earlier treatment with physical rehabilitation can prevent these pathogenetic processes effectively. Biomechanical method and related theory of higravity might be useful in directing this effective treatment and other new approaches.