重心移动式步行矫形器对截瘫患者膀胱和肠道功能的影响

目的 应用自行研制的重心移动式步行矫形器(RGO).配合综合系统康复训练,帮助脊髓损伤截瘫患者改善膀胱和直肠功能.方法 先后为12例T4～L1节段完全性脊髓损伤患者装配RGO,并于安装前后对其进行综合系统的康复训练.分别于装配前和装配后3个月进行冷水试验、尿细菌培养和结肠排空实验,并检测患者的膀胱容量、残余尿量、膀胱充盈压及平均直肠压.结果 12例截瘫患者装配RGO前后的冷水实验均为阳性;但其尿细菌培养结果示,装配RGO前11例为阳性,装配后仅1例阳性.装配RGO 3个月后的膀胱容量和平均直肠压较装配前显著提高(P<0.05);而残余尿量、膀胱内压及平均结肠排空时间均显著降低(P<0.05).结论 应用RGO并配合综合系统康复训练可以有效地改善截瘫患者的膀胱和直肠功能,提高生存质量,值得临床推广应用.

Beneficial effects of reciprocating gait orthosis on bladder and bowel functions in paraplegia patients

OBJECTIVE: To evaluate the beneficial effects of application of a self-designed reciprocating gait orthosis (RGO) combined with comprehensive rehabilitation training on bladder and bowel function in paraplegic patients sustaining spinal cord injuries (SCI). METHODS: Twelve paraplegic patients with complete spinal cord injury at the levels between T(4) and L(1) received the RGO with a comprehensive rehabilitation exercise program carried out before and after fixing. Cold water and colon excretion tests were performed before and 3 months after application of the RGO, and the bladder volume, residue bladder volume, and bladder and bowel pressures were measured in these patients. RESULTS: The 12 paraplegic patients all showed positive results in cold water test before and after RGO application. Before RGO application, 11 of these patients were positive for urine bacteria and only 1 patient was still positive 3 months after the application. The bladder volume and bowel pressure of the patients were significantly increased (P<0.05), while the residue volume and pressure of the bladder were significantly reduced 3 months after RGO application (P<0.05). CONCLUSION: RGO combined with comprehensive rehabilitation training can effectively improve the bladder and bowel function and the quality of life of patients with complete spinal cord injury, suggesting much clinical value for its extensive application.