高压氧对脊髓损伤肌张力控制的队列研究  

Cohort study of hyperbaric oxygention(HBO) in controlling hypermyotonia caused by spinal cord injury

作　　者：卢爱兰[1] 张夏军[1] 许美飞[1] 

机构地区：[1]金华市中心医院康复科,浙江金华321000

出　　处：《中国骨伤》2012年第9期743-746,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨高压氧(hyperbaric oxygenation,HBO)对脊髓损伤(spinal cord injury,SCI)肌张力增高患者的治疗效果。方法:选择2009年3月至2011年4月脊髓损伤肌张力增高患者80例作为研究对象,男49例,女31例;年龄17～60岁,平均(34.12±6.61)岁;病程14～30d,平均(20.16±5.08)d。按就诊顺序、是否愿意同时进行高压氧治疗分成治疗组和对照组。其中治疗组40例,在运动康复训练和巴氯芬药物治疗的基础上,加用HBO治疗。治疗压力为2ATA;治疗方案为:面罩吸氧20min,休息5min,反复3个循环为1次,每日1次,10d为1个疗程,共治疗6个疗程。对照组40例,只进行运动康复训练和巴氯芬药物治疗,疗程同治疗组。两组均按国际通用修订的Ashworth评分(modified ash worth scale,MAS)方法分别于治疗3个疗程和6个疗程时对肌张力进行评估。结果:治疗3个疗程时对肌张力的控制,治疗组有效5例,显效0例;对照组有效4例,显效0例。治疗6个疗程时对肌张力的控制,治疗组有效24例,显效5例;对照组有效14例,显效2例。3个疗程时,治疗组与对照组疗效差异无统计学意义(P=0.508);6个疗程时治疗组疗效优于对照组(P<0.05)。结论:HBO对脊髓损伤肌张力增高患者有治疗作用,可作为一种常规辅助治疗方法,在临床上值得推广应用,但需要足够的疗程。Objective：To evaluate the clinical effects of hyperbaric oxygention （HBO） in treating hypermyotonia caused hy spinal cord injnry（SCI）. Methods ：From March 2009 to April 2011,80 patients with hypermyotonia caused by SCI were divided into treatment group and control group ,with 40 cases in each group. There were 49 males and 31 females with an average age of （34.12±6.61） years （ranged, 17 to 60） in the study. Course of disease was from 14 to 30 d with an average of （20.16± 5.08） d. The patients of the treatment group were treated with HBO,rehabilitation exercise and baclofen medication. With pressure of HBO was 2ATA ,the treatment project including mask oxygen-inspiration for 20 minutes and resting 5 min ,repeating 3 circulations as once,once every day and 10 times as a course of treatment, a total of 6 courses. In the control group,the patients were only treated with rehabilitation exercise and baclofen medication. Course of treatment was same with treatment group. The muscular tensions of patients were evaluated according to method of Modified Ashworth scale （MAS） at 3 courses and 6 courses after treatment. Results： After 3 courses of treatment, 5 cases were effective in treatment group and 4 cases were effective in control group. There was no significant difference between two groups. After 6 courses of treatment, 24 cases were effective and 5 cases were obvious effective in treatment group ; 14 cases were effective and 2 cases were obvious effective in control group. Clinical effect of treatment group was better than that of control group after 6 courses of treatment. Conclusion： HBO was effective to controlling hypermyotonia caused by SCI,it can be used widely as a routine adjuvant therapy in clinic, hut adequate course of treatment is necessary.

关 键 词：脊髓损伤 肌张力 高压氧 队列研究 

分 类 号：R442.6[医药卫生—诊断学]