心理康复对脊柱骨折所致截瘫患者康复疗效的影响  

Psychological rehabilitation of paraplegic patients with spinal fracture

作　　者：郝又国[1] 陆伟伟[1] 施海燕[1] 李旭[1] 陈康[1] 

机构地区：[1]上海交通大学附属第一人民医院松江分院,上海市松江区中心医院康复科,上海201600

出　　处：《中华物理医学与康复杂志》2014年第6期437-439,共3页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：上海市卫生局科研计划项目（20114330）;松江区医学领先项目（2011LX13,2012-Ⅲ-08）;上海市松江区科技攻关项目

摘　　要：目的观察心理康复对脊髓损伤后截瘫患者的康复疗效。方法选取脊柱骨折致截瘫患者100例，按随机数字表法分为研究组和对照组，每组50例。2组患者均接受常规康复训练，研究组在常规康复训练的基础上增加心理康复治疗，均30d为1个疗程，连续治疗2个疗程。分别于治疗前和治疗2个疗程后（治疗后），采用Barthel指数（BI），功能独立性评定量表（FIM），汉密尔顿抑郁量表（HAMD）和汉密顿焦虑量表（HAMA）分别评定2组患者的日常生活活动能力、运动功能、抑郁状态和焦虑状况。结果治疗前，2组患者各项指标组间差异均无统计学意义（P〉0．05）；治疗后，研究组的B1、FIM、HAMD和HAMA评分改善情况均显著优于组内治疗前和对照组治疗后，差异均有统计学意义（P〈0．05）。HAMD评分与BI和FIM评分的Pearson相关系数分别为-0．541和-0．427，差异有统计学意义（P〈0．05），即HAMD评分与BI和FIM评分具有显著相关性。HAMA评分与BI和FIM评分的Pearson相关系数分别为-0．640和-0．559，差异均有统计学意义（P〈0．05），即HAMA评分与BI和FIM评分具有显著相关性。结论心理康复有利于截瘫患者的功能恢复。Objective To study the effects of psychological rehabilitation in the treatment of paraplegic patients with spinal cord injury （SCI）. Methods A hundred paraplegic spinal fracture survivors were divided into a research group and a control group with 50 cases in each. Systematic rehabilitation was given to the patients in the control group, while this was combined with individualized psychological rehabilitation protocols for the patients in the research group. The daily treatment lasted 10 weeks, 6 days a week. All of the patients were assessed with the Barthel index （BI）, a functional independence measure （FIM）, the Hamilton depression scale （HAMD） and the Hamilton anxiety scale （HAMA） pre-treatment and post-treatment. Results Before the intervention there was no significant difference between the 2 groups in any of the assessments. After ten weeks the average BI, FIM, HAMD and HAMA results in the research group were significantly better than those pre-treatment and also significantly better than those in the control group. Conclusions Psychological rehabilitation can distinctly improve the functioning and psychological state of paraplegic patients after SCI.

关 键 词：脊柱骨折 截瘫 心理康复 

分 类 号：R683[医药卫生—骨科学]