综合康复疗法治疗汶川地震伤员周围神经损伤24例临床疗效观察

目的报告综合康复治疗方法对汶川地震伤员周围神经损伤的治疗效果。方法对四川大学华西医院地震伤员医疗康复中心符合纳入标准的24例周围神经损伤患者，进行包括运动疗法、针刺疗法、功能性电刺激及作业治疗（感觉训练、矫形器的佩戴为主）等综合康复治疗。治疗30次后，采用英国医学研究会BMRC周围神经损伤后的运动功能恢复等级及周围神经损伤后感觉功能恢复等级评定、上肢功能活动的评定及电诊断检查评价疗效，同时记录合并损伤情况。结果治疗后24例BMRC周围神经损伤患者的运动功能恢复等级及感觉功能恢复等级评价的疗效优良率为41．66％；简易上肢机能检查治疗前后评分差值差异有统计学意义（P〈0．01）；肌电图、神经传导速度检测评定治疗前后疗效有效率87．50％。合并损伤越多，恢复越差。结论综合康复治疗可明显改善汶川地震伤员周围神经损伤的运动和感觉功能障碍。

Therapeutic Effect of Comprehensive Rehabilitation in Patients with Peripheral Nerve Injuries after the Wenchuan Earthquake:A Report of 24 Cases

Objective To observe the effect of comprehensive rehabilitation in patients with peripheral nerve injuries after the Wenchuan earthquake.Methods A total of 24 cases of peripheral nerve injuries who were admitted to the Rehabilitation Center for Earthquake Victims of West China Hospital of Sichuan University were treated with comprehensive rehabilitation,including exercise therapy,acupuncture therapy,functional electrical stimulation,and occupational therapy(mainly sensory training and wearing orthosis).After 30 treatment sessions,patient motor and sensory function,upper limb functional activity,and electrodiagnostic parameters were evaluated.Meanwhile,concomitant injuries were also recorded.Results As for the recovery of motor and sensory functions,the effective rate was 41.66%.The difference in the scores of upper limb functional activities was statistically significant before and after treatment(P<0.01).As assessed by electromyogram and nerve conduction velocity,the response rate was 87.50%.Patients with more concomitant injuries were likely to have slower recovery.Conclusion Comprehensive rehabilitation is appropriate and effective for patients with peripheral nerve injuries after the Wenchuan earthquake.