经皮脉冲磁刺激骶髓神经治疗截瘫患者便秘的效果  

Effect of percutaneous pulsedmagnetic stimulation of the sacral nerve for the treatment of paraplegic patients with constipation

作　　者：赵坚[1] 江仕君[1] 孙艺玮[1] 周粤瑛[1] 

机构地区：[1]暨南大学医学院附属二院深圳市人民医院脊柱外科,518020

出　　处：《中华现代护理杂志》2014年第17期2085-2087,共3页Chinese Journal of Modern Nursing

基　　金：基金项目：深圳市科技局立项课题（201202109）

摘　　要：目的：观察应用经皮脉冲磁刺激脊柱T12-L1椎体水平（骶2～4脊髓）副交感节前神经，对促进截瘫患者胃肠蠕动，缓解便秘症状的影响。方法将52例患者按入院日期奇偶数分为两组。对照组进行常规护理，包括心理护理、药物干预、饮食结构、水平衡、下腹部按摩方法、灌肠、盆底肌训练及高压氧的治疗。干预组在常规护理的基础上，脊髓损伤早期行经皮脉冲磁刺激脊柱 T12-L1椎体水平（骶2-4脊髓）副交感节前神经，以促进受损排便神经功能的恢复。观察两组患者的排便情况和疗效。结果干预组除颈椎骨折脱位并高位截瘫1例、脊柱原发肿瘤侵犯脊髓马尾神经2例效果不明显外，有规律排便率为88．46％（23/26），而对照组患者仅为61．54％（16/26），两组比较差异有统计学意义（χ2＝5．026，P＜0．05）。干预组有效率为76．9％（20/26），明显高于对照组50．0％（13/26），两组比较差异有统计学意义（χ2＝4．046，P＜0．05）。结论通过经皮脉冲磁刺激骶髓2～4副交感节前神经，改善支配排便神经功能的恢复，为截瘫后便秘患者提供无痛、无创、简单的治疗方法，减少便秘给患者带来的不便及痛苦，提高患者生活的质量。Objective To observe the effect of percutaneous pulsedmagnetic stimulation of the preganglionic parasympathetic nervous system of spinal at T 12-L1 vertebral level （2-4 sacral spinal cord）, in order to promote gastrointestinal peristalsis paraplegics and relieve symptoms of constipation .Methods Totals of 52 patients were divided into two groups by their admission date .The control group were applied the routine nursing care, including the psychology nursing care , drug intervention, diet, water balance, lower abdominal massage therapy, enema, pelvic floor muscle training and hyperbaric oxygen therapy .Based on the routine care, the intervention group was given the early percutaneous spinal cord pulsed magnetic stimulation of the preganglionic parasympathetic nerves of the spine at T 12 -L1 vertebral level （ 2 -4 sacral spinal cord ） . Results In the intervention group , 1 patient had cervical fracture and dislocation;2 patients had tumor invasion of the primary caudaequina of spinal cord.88.46%（23/26） patients had regular bowel movements.In the control group, only 61.54% （16/26） patients had regular bowel movements.The difference was statistically significant （χ2 =5.026,P〈0.05）.The effective rate of the intervention group was 76.9%（20/26）, which was significantly higher than 50.0% （13/26） in the control group （χ2 =4.046,P〈0.05）.Conclusions Percutaneous pulsed magnetic stimulation of the parasympathetic preganglionic nerve can improve the recovery of neurological function and provide a simple , noninvasive and painless method to reduce the constipation and improve patients ’ quality of life.

关 键 词：便秘 截瘫 经皮脉冲磁刺激 

分 类 号：R473.6[医药卫生—护理学]