高压氧联合经颅磁刺激治疗脊髓损伤运动功能障碍患者的临床观察

Clinical observation of hyperbaric oxygen combined with transcranial magnetic stimulation in the treatment of motor dysfunction after spinal cord injury

目的探讨高压氧(HBO)联合经颅磁刺激(TMS)治疗脊髓损伤(SCI)运动功能障碍患者的临床疗效。方法选取2017年4月至2021年3月日照市人民医院和山东中医药大学附属医院收治的98例SCI运动功能障碍患者作为研究对象,按随机数字表法分为观察组和对照组,每组49例。对照组给予常规治疗和TMS治疗,观察组在此基础上联合HBO治疗。比较2组患者治疗前后的美国脊髓损伤协会(ASIA)损伤分级、ASIA运动评分(MS)、ASIA感觉指数评分(SIS)及日常生活活动(ADL)能力评分。结果治疗前2组患者的ASIA损伤分级差异无统计学意义(Z=0.472,P>0.05);2组患者治疗后均有好转,且观察组显著优于对照组,差异均有统计学意义(Z=3.104,P<0.01)。治疗前2组患者的MS、SIS、ADL能力评分差异无统计学意义(t=0.077、0.136、0.252,P>0.05);治疗后2组患者的MS、SIS、ADL能力评分均升高,且观察组显著优于对照组,差异均有统计学意义(P<0.01)。结论采用HBO联合TMS治疗SCI运动功能障碍患者可促进运动、感觉功能恢复,改善日常生活能力,值得临床推广应用。

Objective To observe the clinical effect of hyperbaric oxygen(HBO)combined with transcranial magnetic stimulation(TMS)on patients with motor dysfunction after spinal cord injury(SCI).Methods A total of 98 patients with motor dysfunction due to SCI treated in People’s Hospital of Rizhao and Affiliated Hospital of Shandong University of Traditional Chinese Medicine from April 2017 to March 2021 were selected as the research subjects,who were divided into observation group and control group according to the random number table method,with 49 cases in each group.The control group was given conventional treatment and TMS,and the observation group was given HBO on this basis of the treatments of the control group.The injury classification of American Spinal Cord Injury Association(ASIA),ASIA motor score(MS),ASIA sensory index score(SIS),and activity of daily living(ADL)ability score were compared between the two groups before and after treatment.Results There was no significant difference in ASIA injury grade between the two groups before treatment(Z=0.472,P>0.05).After treatment,the patients in both groups are recovering,and the improvement in the observation group was significantly better than that of the control group,with a statistically significant difference(Z=3.104,P<0.01).There was no significant difference in MS,SIS,or ADL scores between the two groups before treatment(P>0.05).After treatment,the MS,SIS,and ADL ability scores of patients in both groups increased,and the scores in the observation group were all significantly higher than those in the control group,with statistically significant differences(P<0.01).Conclusion HBO combined with TMS can promote the recovery of motor and sensory disorders and improve the ability of daily living in SCI patients with motor dysfunction,which is worthy of wide application.