脊柱伴脊髓损伤高压氧治疗的临床疗效及影响因素分析

Clinical efficacy and influencing factors of hyperbaric oxygen therapy for spine and spinal cord injury

目的探讨高压氧(HBO)治疗脊柱伴脊髓损伤患者的临床疗效及影响因素。方法选取2017年5月至2019年5月在庆阳市人民医院收治的脊柱伴脊髓损伤患者150例,按照随机数字表法分为HBO组和对照组,每组75例。2组患者均给予常规基础治疗,HBO组患者在此基础上给予HBO治疗。观察2组患者的治疗效果及治疗前后神经功能Frankel分级的变化,收集HBO组患者年龄、损伤部位、受伤原因、损伤程度、术后HBO开始治疗时间、术后HBO治疗次数等资料,Logistic回归分析影响HBO治疗效果的危险因素。结果HBO组患者治疗总有效率(88.00%)显著高于对照组(61.33%)(P<0.01);治疗后HBO组A级患者占比(2.67%)显著低于对照组(13.33%),E级患者占比(28.00%)显著高于对照组(12.00%),差异均具有统计学意义(P<0.05)。脊柱伴脊髓损伤患者损伤程度、术后HBO开始治疗时间及HBO治疗次数均为HBO临床疗效的影响因素(P<0.05或P<0.01)。Logistic回归分析结果显示,术后HBO开始治疗时间为HBO临床疗效的危险因素(P<0.05)。结论HBO治疗脊柱伴脊髓损伤临床疗效显著,可明显促进患者神经功能的恢复,其中术后HBO开始治疗时间为影响HBO治疗脊柱伴脊髓损伤效果的危险因素,建议术后8 h内进行HBO治疗更有利于患者神经功能的恢复。

Objective To observe the clinical efficacy and influencing factors of hyperbaric oxygen(HBO)in the treatment of spine and spinal cord injuries.Methods A total of 150 patients with spinal cord injuries admitted to Qingyang People’s Hospital from May 2017 to May 2019 were randomly divided into hyperbaric oxygen(HBO)group and control group,with 75 cases in each group,according to random number table method.The patients in both groups were given basic conventional treatment,and HBO treatment was added to the patients in the HBO group.The clinical efficacy and Frankel grades of neurological function before and after treatment were observed.The data of age,injury site,injury reason,injury severity,starting time of the postoperative HBO treatment,and times of HBO treatment in the HBO group were collected and analyzed by Logistic regression analysis for studying the risk factors affecting HBO clinical efficacy.Results The total effective rate of the HBO group(88.00%)was significantly higher than that of the control group(61.33%)(P<0.01);after treatment,the proportion of Grade A patients in the HBO group(2.67%)was significantly lower than that of the control group(13.33%),while the proportion of Grade E patients(28.00%)in the HBO group was significantly higher than that of the control group(12.00%),with statistically significant difference(P<0.05).The injury severity,the starting time of postoperative HBO treatment,and the times of HBO treatment were the influencing factors of the HBO clinical efficacy for the patients with spine and spinal cord injuries(P<0.05 or P<0.01).Logistic regression analysis showed that the starting time of postoperative HBO treatment was the risk factor of the HBO clinical efficacy(P<0.05).Conclusion HBO can achieve an obvious efficacy in treating spine and spinal cord injuries by significantly promoting the recovery of neurological function.The starting time of postoperative HBO treatment is a risk factor of the HBO treatment of spine and spinal cord injuries.It suggests that HBO treatment should be carried out within 8 hours after operation,which can be more conducive to the recovery of neurological function.