高压氧治疗职业性手臂振动病的疗效分析  

Treatment of patients with occupational hand-arm vibration disease with hyperbaric oxygen therapy

作　　者：王艳艳[1] 郎丽[1] 樊春月[1] 张莹[1] 程樱[1] 

机构地区：[1]广东省职业病防治院,广东广州510260

出　　处：《职业卫生与应急救援》2016年第3期179-182,共4页Occupational Health and Emergency Rescue

基　　金：国家临床重点专科建设项目(编号:2011-09)

摘　　要：目的探讨高压氧治疗职业性手臂振动病(hand-arm vibration disease,HAVD)的临床疗效和安全性。方法 2010年1月至2013年8月,选择108例职业性手臂振动病患者,随机分为高压氧综合治疗组(HBO组)和常规中西医治疗组(对照组),对照组予改善循环、营养神经、针灸、理疗等中西医综合治疗,HBO组在常规中西医治疗基础上同时进行高压氧治疗。治疗结束后比较两组患者的临床资料、神经肌电图、冷水复温试验指标及不良反应情况。结果两组治疗后的症状和体征均有改善。HBO组治疗手麻症状、痛觉减退、触觉减退、振动觉减退的总有效率优于对照组,差异均有统计学意义(P<0.05)。HBO组正中神经、尺神经的运动传导速度、运动远端潜伏期、感觉传导速度改善情况均优于对照组,差异均有统计学意义(P<0.05)。HBO组左、右手的5 min、10 min复温试验总有效率优于对照组,差异均有统计学意义(P<0.05)。结论HBO联合中西医治疗职业性HAVD疗效显著,能改善患者临床症状、体征、冷水复温率、神经肌电图,且较为安全,值得推广应用。Objective To observe the clinical efficacy and safety of hyperbaric oxygen therapy in the treatment of patients with occupational hand-arm vibration disease. Methods From January 2010 to August 2013,a total of 108 patients with hand-arm vibration disease were randomly divided into the hyperbaric oxygen therapy group （HBO group）and the regular group. The patients in the regular group were treated with integrated traditional Chinese and western medicines,such as circulation improvement,nerve nutrition, acupuncture and physical therapy. The patients in the HBO group were additionally treated with hyperbaric oxygen therapy besides the same treatment as the regular group. After the treatment,the therapeutic effects were compared between these two groups through the analysis of clinical data,electroneuromyography, cool water loading test and adverse reactions. Results Compared with the regular group,the HBO group had more effective symptom relief in hand numbness,hypalgesia, hypopselaphesia and pallhypesthesia （P 〈 0.05）. The electroneuromyography examination showed that motor nerve conduction velocity, sense nerve conduction velocity and motor digital latency of median nerve and ulnar nerve were significantly improved in the HBO group. The cool water loading test showed that 5 rain rewarming rate and 10 rain rewarming rate of both left and right hands in the HBO group were improved more effectively compared with the regular group （P 〈 0.05）. Conclusion The research has demonstrated the clinical efficacy of hyperbaric oxygen therapy in the treatment of occupational hand-arm vibration disease. Being safe and effective, this therapy is worth recommending.

关 键 词：职业性手臂振动病 高压氧 疗效 

分 类 号：R135.1[医药卫生—劳动卫生]