高压氧治疗脊髓损伤神经源性肠道功能障碍的疗效观察

Therapeutic effect of hyperbaric oxygen on neurogenic intestinal tract caused by spinal cord injury

目的 探讨高压氧联合综合康复疗法在脊髓损伤神经源性肠道功能障碍(neurogenic bowel dysfunction,NBD)患者中的临床疗效。方法 选取2020年9月至2022年6月于浙江中医药大学附属第一医院治疗的120例脊髓损伤NBD患者,采用随机数字表法将其分为对照组(n=60)和观察组(n=60)。对照组给予综合康复治疗,观察组患者在对照组基础上联合高压氧治疗。比较两组患者治疗前与治疗后的NBD评分、3D高分辨率肛门直肠测压数据和生存质量测定量表(World Health Organization quality of life,WHOQOL)。结果 治疗后,观察组的约肌静息压、高压带长度、肛管压力差、肛门收缩压、直肠压力指均显著优于治疗前(P<0.05),除高压带长度以外,其他指标均显著优于对照组(P<0.05)。治疗后,观察组的前25项WHOQOL评分、食欲评分均显著高于对照组(P<0.05),NBD评分显著低于对照组(P<0.05)。结论 应用高压氧联合综合康复疗法可更好地改善NBD患者的肠道动力指标和日常生活质量。

Objective To investigate the clinical efficacy of hyperbaric oxygen combined with comprehensive rehabilitation therapy in patients with neurogenic bowel dysfunction(NBD)of spinal cord injury.Methods A total of 120 patients with NBD of spinal cord injury treated in the First Affiliated Hospital of Zhejiang Chinese Medical University from September 2020 to June 2022 were divided into control group(n=60)and observation group(n=60)according to random number table method.The control group was given comprehensive rehabilitation treatment,and the patients in the observation group were combined with hyperbaric oxygen therapy on the basis of the control group.The NBD score,3D high-resolution anorectal manometry data and World Health Organization quality of life(WHOQOL)scale were compared between the two groups before and after treatment.Results After treatment,the approximate muscle resting pressure,high pressure band length,anal canal pressure difference,anal systolic pressure,rectal pressure finger of the observation group were significantly better than those before treatment(P<0.05),and except for the high pressure band length,all others were significantly better than those of the control group(P<0.05).After treatment,the first 25 WHOQOL scores and appetite scores of the observation group were significantly better than those of the control group(P<0.05),and the NBD score were significantly lower than that of the control group(P<0.05).Conclusion The application of hyperbaric oxygen combined with comprehensive rehabilitation therapy can better improve the index of intestinal motility and the quality of daily life in patients with NBD.