体外反搏治疗小儿急性脑外伤的临床应用分析

Clinical Application of External Counterpulsation in the Treatment of Acute Traumatic Brain Injury in Children

目的:探讨以体外反搏为主的综合康复治疗对脑外伤后偏瘫患儿运动功能和日常生活活动能力(ADL)的影响。方法:选择2015年7月至2017年7月我院神经外科收治的脑外伤后偏瘫患儿46例,将其随机分为对照组和治疗组。两组患者均采用常规的康复治疗和护理,对照组采取常规的物理治疗(PT治疗),治疗组患者给予以体外反搏为主的综合康复治疗。于治疗1、3个月后,评价和比较两组患者粗大运动能力(GMFM)评分、精细运动能力(FMFM)评分和日常生活能力(ADL)评分的变化。结果:治疗1、3个月后,两组患儿GMFM、FMFM评分均较治疗前明显增加(均P<0.01),而治疗组治疗后GMFM、FMFM评分均明显高于对照组(均P<0.01)。两组治疗一个月后ADL总有效率(显效率与有效率之和)分别为90.48%和76.19%,治疗三个月后分别为95.24%和85.71%,治疗组均显著高于对照组(均P<0.05)。结论:以体外反搏为主的综合康复治疗有利于促进脑外伤后偏瘫患者ADL及部分运动功能的提高。

Objective:To explore the effect of comprehensive rehabilitation therapy based on external counterpulsation on motor function and activities of daily living(ADL)in children with hemiplegia after traumatic brain injury.Methods:From July 2015 to July2017,46 cases of post-traumatic hemiplegic children admitted to our department of neurosurgery were randomly divided into control group and treatment group.The two groups were treated with routine rehabilitation and nursing,and the control group was treated with conventional physical therapy(PT),and the patients in the treatment group were given a comprehensive rehabilitation treatment based on external counterpulsation.After 1 and 3 months of treatment,the changes of the gross functional exercise(GMFM)score,the fine motor function(FMFM)score and the daily living ability(ADL)score of the two groups were evaluated and compared.Results:After 1 and 3 months of treatment,the scores of GMFM and FMFM in the two groups were significantly higher than before the treatment(P<0.01),while the GMFM and FMFM scores in the treatment group were significantly higher than those in the control group(P<0.01).The total effective rate of ADL(the sum of effective and effective rate)of the two groups after one month was 90.48%and 76.19%respectively.The treatment group was 95.24%and 85.71%after three months,and the treatment group was significantly higher than the control group(P<0.05).Conclusion:The comprehensive rehabilitation therapy based on external counterpulsation was beneficial to the promotion of ADL and GMFM partial transport of patients with hemiplegia after brain injury.