康复治疗对脊髓损伤患者远期功能独立性的影响

发布时间：2018-03-17 19:17

本文选题：脊髓损伤　切入点：康复治疗　出处：《临床医学研究与实践》2016年21期 　论文类型：期刊论文

【摘要】：目的探讨康复治疗对脊髓损伤患者远期功能独立性的影响。方法对我院收治的642例外伤性脊髓损伤患者远期功能独立性进行回顾性总结分析,按是否进行康复治疗分为康复组和对照组。康复组334例,其中四肢瘫(颈5以下脊髓损伤)70例(完全瘫39例、不全瘫31例);下肢瘫264例(完全瘫145例、不全瘫119例);对照组308例,其中四肢瘫(颈5以下脊髓损伤)56例(完全瘫32例、不全瘫24例),下肢瘫252例(完全瘫140例,不全瘫112例)。康复组于手术拆线或病情稳定后进行康复治疗,应用Barthel指数对康复治疗组于康复治疗结束时和远期随访时的功能独立性进行测评,对照组(因经济原因或其他因素未行康复治疗)于出院时和远期随访时进行功能独立性测评。结果对资料较完整的642例患者进行8~24年的随访,早期康复组四肢瘫Barthel指数为全瘫(41.2±7.2),不全瘫(55.3±11.4),下肢瘫Barthel指数为全瘫(65.8±10.9),不全瘫(83.7±9.4),对照组四肢瘫Barthel指数为全瘫(26.5±6.3),不全瘫(31.2±6.7),下肢瘫Barthel指数为全瘫(41.6±11.2),不全瘫(49.4±13.6),康复组Barthel指数明显高于对照组,差异有统计学意义(u2.58,P0.01);远期随访康复组四肢瘫Barthel指数为全瘫(44.5±8.3),不全瘫(58.7±10.4),下肢瘫Barthel指数为全瘫(68.9±11.3),不全瘫(87.4±13.0),对照组四肢瘫Barthel指数全瘫(28.7±5.9),不全瘫(30.5±5.9),下肢瘫Barthel指数全瘫(43.4±6.7),不全瘫(52.3±11.4),康复组明显高于对照组,差异有统计学意义(u2.58,P0.01);并且康复组指数远期较早期有显著提高,差异具有统计学意义(1.96u2.58,0.05P0.01),而对照组下肢不全瘫指数较早期有所提高,差异有统计学意义(1.96u2.58,0.05P0.01)。结论有效的康复治疗不但能够改善患者早期的生活自理能力,而且能使患者的远期功能有持续改善,同时可显著降低并发症的发生。从而有效提高了患者的生存质量,为其回归家庭和社会创造条件。
[Abstract]:Objective to explore the effect of rehabilitation therapy on the long-term functional independence of patients with spinal cord injury. Methods 642 patients with traumatic spinal cord injury treated in our hospital were retrospectively analyzed. Patients in rehabilitation group were divided into rehabilitation group (n = 334) and control group (n = 334), including 70 cases of quadriplegia (spinal cord injury below neck 5) (39 cases of complete paralysis, 31 cases of incomplete paralysis, 264 cases of lower extremity paralysis (145 cases of complete paralysis). 119 cases of incomplete paralysis and 308 cases of control group, including 56 cases of quadriplegia (32 cases of complete paralysis, 24 cases of incomplete paralysis, 252 cases of lower extremity paralysis, 140 cases of complete paralysis). The functional independence of rehabilitation group at the end of rehabilitation and long term follow-up was evaluated by Barthel index. The functional independence of the control group (for economic reasons or other factors) was evaluated at discharge and long-term follow-up. Results 642 patients with complete data were followed up for 8 ~ 24 years. In the early rehabilitation group, the Barthel index of quadriplegia was 41.2 卤7.2, the Barthel index of incomplete paralysis was 55.3 卤11.4m, the Barthel index of lower extremity paralysis was 65.8 卤10.9m, the index of incomplete paralysis was 83.7 卤9.4m, the Barthel index of quadriplegia in control group was 26.5 卤6.3m, the Barthel index of incomplete paralysis was 31.2 卤6.7m, the Barthel index of lower extremity paralysis was 41.6 卤11.2m, the index of incomplete paralysis 49.4 卤13.6m, the Barthel index of rehabilitation group was 41.6 卤11.2m and 49.4 卤13.6m respectively. Significantly higher than the control group, The Barthel index of quadriplegia in rehabilitation group was 44.5 卤8.3, the Barthel index of incomplete paralysis was 58.7 卤10.4m, the Barthel index of lower extremity paralysis was 68.9 卤11.3m, the index of incomplete paralysis was 87.4 卤13.0m, the Barthel index of control group was 28.7 卤5.9m, the index of incomplete paralysis was 30.5 卤5.9m, the Barthel index of lower extremity paralysis was 43.4 卤6.7m. The total paralysis group was 52.3 卤11.4m, and the rehabilitation group was significantly higher than the control group. The difference was statistically significant, and the index of rehabilitation group was significantly higher than that of early stage, the difference was statistically significant, and the index of incomplete paralysis of lower extremity in control group was higher than that in early stage. Conclusion effective rehabilitation therapy can not only improve the self-care ability of the patients in early life, but also improve the long-term function of the patients. At the same time, it can significantly reduce the incidence of complications, thus effectively improve the quality of life of patients, and create conditions for their return to their families and society.
【作者单位】：西安交通大学附属红会医院;
【分类号】：R473.6

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