脊髓损伤术后长时间制动对患者术后恢复的影响

The Impairment of Immobilization in Recovery of Patient with Spinal Cord Surgery

本研究目的是探讨脊髓损伤术后长时间制动对患者术后恢复的影响。选取腰椎骨折患者60例,所有患者均进行了手术治疗;有30例患者术后早期主被运动称为运动组,另外30例患者完全制动称为制动组,观察两组患者在治疗后4周和治疗后8周的ASIA和WISCIⅡ运动评分,同时观察两组患者在术前、治疗后第1周、4周和8周的双下肢主动关节评分。分析两组患者的下肢主要关节的活动度,在第1周、第4周和第8周时均存在差异(p<0.05),制动组患者主动关节活动度比运动组明显受限。两组患者在手术治疗后随着时间延长,运动能力均显著改善,前后评分存在统计学差异(p<0.05);发现第4周时两组患者的ASIA运动评分存在差异(p<0.05),而WISCIⅡ运动评分无明显差异(p>0.5);第8周时两组患者的两个运动评分存在显著差异,差异具有统计学意义(p<0.05),其中制动组的患者在第8周时运动能力显著低于运动组的患者。脊髓损伤术后制动时间过长严重影响患者的术后运动恢复,应合理管理患者的术后制动时间,同时制动期间即使简单的主被动运动也促进患者术后恢复。

The study aimed to explore the impairment of immobilization in recovery of patient with spinal surgery. 60 cases with spinal fracture were divided into motion group and immobilization group equally. Motion function of two groups were measured by using ASIA and WISCI Ⅱ scale during fourth and eighth week. Range of motion of two groups were also measured during first, fourth and eighth week. The range of motion of motion group during first, fourth and eighth week was all higher than immobilization group during corresponding time （p〈0.05）. ASIA score of motion group was different with immobilization group at fourth week （p〈0.05）, however there is no difference for WISCIⅡ score （p〉0.5）. the scores of ASIA and WlSCI Ⅱ of immobilization group were significantly different from motion group （p 〈0.05）. Long time of immobilization can impair the motion function of spinal cord injury patients. Even simple active/passive motion can help the recovery of motion during immobilization.