康复治疗脊髓损伤功能恢复的疗效观察

目的研究康复治疗对脊髓损伤患者的运动功能,感觉平面恢复,排尿功能及ADL等的影响,为脊髓康复程序化治疗提供可靠的依据.方法脊髓损伤患者32例,损伤水平颈段11例,胸段9例,腰段12例.发病后距康复治疗时间为1～10个月,平均(4.8±3.6)个月,康复治疗持续时间为58～90d.采取运动功能训练,ADL训练,理疗,心理疏导等方法,进行运动平面总积分,感觉平面总积分,排尿功能分级,Barthel指数的评定.结果32例脊髓损伤患者治疗后运动平面总积分(55.88±16.48),感觉平面总积分(68.09±17.63),排尿功能分级(2.03±1.57)及Barthel指数(67.81±20.54),与康复治疗前比较差异均有非常显著性(P＜0.001);9例完全性脊髓损伤中,经康复治疗后,运动平面总积分,感觉平面总积分及Barthel指数均有明显提高(P＜0.05),而排尿功能分级改变不大(P＞0.05).结论脊髓损伤患者有一定恢复的潜力,不完全性脊髓损伤的恢复潜力较大.完全性脊髓损伤的排尿功能分级康复治疗前后变化不大,但运动功能、感觉功能及ADL均有明显改善.

Curative observation on function recovery in patients with spinal cord injuries

Objective To study the recovered levels of motor function,feeling of horizon function,urination function and ADL in spinal cord injuries patients with rehabilitation comprehensive programmes and provide an evidence for rehabilitation treatment. Methods 32 cases with spinal cord injuries(thst is,cervical region 11 cases,thoracic region 9 and lumbar region 12) were treated with rehabilitation comprehensive treatment including the physiotherapies,PT,OT,acupuncture,massage,motor function and ADL function training,psychotherapy etc.for 58 to 90 days.Then,the movement level score,feeling level score,urination function scale and Batthel index were calculated and compared at pre-rehabilitation treatment and post rehabilitation treatment. Results It was found that the movement level score,feeling level score,unination function scale and Barthel index in 32 cases at post-rehabilitation were all better than the pre-rehabilitation,there was a significant difference(P<0.001).In 9 cases with complete spinal cord injuries,the movement level score,feeling level score and Barthe index after rehabilitation were also improved obviously(P<0.05),but the urination function hadn't improvement. Conclusion It indicates that rehabilitation comprehensive treatment has a better effects for spinal cord injuries patients,particularly in the incomplete spinal cord injuries patients.