胸腰撑开支具联合智能间歇站立床训练对脊髓损伤患者骨密度和骨代谢的影响

目的分析应用胸腰撑开支具联合智能间歇站立床训练对脊柱骨折伴脊髓损伤患者骨密度的影响。方法胸腰椎骨折合并脊髓损伤患者28例,分成观察组与对照组,观察组患者予脊髓损伤常规治疗的同时,穿戴自主研发的胸腰椎撑开支具,于智能间歇站立床早期进行站立训练;对照组因不同原因延长术后卧床时间,仅接受常规治疗。在治疗前及治疗6周后分别行骨密度、骨代谢标志物检测,同时评估患者站立训练安全性及卧床并发症等。结果对照组腰椎(L1~4)及股骨颈骨密度在治疗后较前下降,差异有统计学意义(P<0.05);观察组治疗后骨密度稍有上升,但差异无统计学意义(P>0.05)。两组患者治疗后骨代谢标志物均有所上升,对照组患的N-MID、β-CTX上升更明显,差异有统计学意义(P<0.05)。结论早期应用胸腰椎撑开支具并联合智能站立床训练,能够有效减少该类患者术后卧床并发症的发生,同时能够延缓骨质流失、改善骨代谢指标进而预防骨质疏松的发生,是一种安全有效的训练方法,值得临床推广。

Objective To analyze the impact of using thoracolumbar brace combined with intelligent standing bed training on bone density in patients with spinal fractures and spinal cord injury.Methods 28 patients with thoracolumbar fracture complicated with spinal cord injury were divided into the study group and the control group.While receiving routine treatment for spinal cord injury,the patients in the study group wore thoracolumbar braces independently developed by our department and performed standing training in the early stage of intelligent intermittent standing bed.The control group received conventional treatment only after prolonged bed rest for different reasons.Bone mineral density and bone metabolism indexes were detected before treatment and after 6 weeks of treatment,and the safety of standing training and bed rest complications were also evaluated.Results The bone mineral density of the lumbar spine(L1~4)and femoral neck of the control group decreased after treatment,and the difference was statistically significant(P<0.05).The bone mineral density of the study group increased slightly after treatment,but the difference was not statistically significant(P>0.05).After treatment,the bone metabolism markers in the two groups were increased,and the N-MID andβ-CTX of the control group increased more significantly,and the difference w as statistically significant(P<0.05).Conclusion Early application of the thoracolumbar spine brace developed by our department and combined with intelligent standing bed training can effectively reduce the occurrence of postoperative bedridden complications in such patients,while delaying bone loss,improving bone metabolism indicators,and preventing osteoporosis.It is a safe and effective training method that is worthy of clinical promotion.