早期综合康复疗法对脊髓损伤患者的康复效果

Effect of early comprehensive rehabilitation therapy on patients with spinal cord injury

目的探讨早期综合康复疗法对改善脊髓损伤(SCI)患者功能康复及生活质量的效果。方法 2016年6月至2017年8月诊疗的SCI患者44例,早期使用糖皮质激素、甘露醇减轻水肿,预防损伤加重,稳定生命体征,辅助微循环药物、营养脑神经药物等基础治疗;同时给予情志护理、按摩、运动与作业康复疗法,并辅助传统中药与电针疗法的早期综合康复疗法。分析患者治疗前与治疗3个月后脊髓功能情况。结果治疗3个月后,患者美国SCI学会(ASIA)分级明显优于治疗前(U=7. 215,P <0. 01),其中治疗前E级为0,治疗后为84. 09%;患者功能独立性测量(FIM)、日常生活活动量表(Barthel指数)、Berg平衡量表(BBS)及健康调查简表(SF-36)(生理功能、躯体疼痛、总体健康、活力、社会功能、精神健康)评分均明显高于治疗前(P均<0. 01);治疗期间,患者并发症发生率为9. 09%。结论早期综合康复疗法治疗SCI患者,能明显改善患者的运动感觉功能、日常生活能力及躯干平衡能力,提高患者的生活质量,并发症少,安全可靠。

Objective To explore the effects of early comprehensive rehabilitation therapy on functional rehabilitation and quality of life in patients with spinal cord injury( SCI). Methods Forty-four SCI patients were selected from June 2016 to August 2017 and treated with glucocorticoids and mannitol to alleviate edema,preventing injury from aggravating and stabilizing vital signs and supplement microcirculation drugs,nutritional brain nerve drugs. At the same time,they were given emotional care,massage,exercise and homework rehabilitation therapy assisted by the early comprehensive rehabilitation therapy of traditional Chinese medicine and electro-acupuncture therapy. Monitoring of spinal cord function before and 3 months after treatment was performed. Results After 3 months of treatment,American Spinal Injury Association( ASIA) grades significantly improved compared with those before treatment( U = 7. 215,P < 0. 01),and ASIA grade E increased significantly( 84. 09% vs 0,P < 0. 01). The scores of functional independence measurement( FIM),Barthel index,Berg balance scale( BBS) and quality of life( physiological function,body pain,general health,vitality,social function and mental health) were significantly higher than those before treatment( all P < 0. 01). During the treatment period,the incidence of complications was 9. 09%. Conclusion Early comprehensive rehabilitation therapy can obviously improve the motor and sensory function,daily life ability and trunk balance,and can increase the quality of life of SCI patients with safety,reliability and fewer complications.