系统运动康复训练对腰椎爆裂骨折所致不完全性截瘫患者的影响  

Effect of systemic exercise rehabilitation training on recovery of spinal cord function in patients with lumbar burst fractures without paraplegia

作　　者：邢政伟[1] 邢松伟 XING Zheng-wei;XING Song-wei(Department of Orthopedics,First Affiliated Hospital of Zhengzhou University,Zhengzhou450044,China;College of Basic Medicine,Zhengzhou University,Zhengzhou450000,China)

机构地区：[1]郑州大学第一附属医院骨科,郑州450044 [2]郑州大学基础医学院,郑州450000

出　　处：《创伤外科杂志》2019年第10期758-760,共3页Journal of Traumatic Surgery

摘　　要：目的探讨系统运动康复训练对腰椎爆裂骨折所致不完全性截瘫患者功能的影响。方法2015年5月—2017年3月郑州大学第一附属医院骨科收治腰椎爆裂骨折所致不完全性截瘫患者80例,按照随机数字表法分为系统康复治疗组(系统组)及被动运动治疗组(被动组),各40例。系统组主要行运动疗法、电动起立床、功能性电刺激等治疗,被动组实施推拿按摩、牵引针灸、高压氧、电刺激等被动治疗。电话随访6个月,比较干预后两组患者下肢感觉及下肢运动恢复时间、骨密度及降钙素水平变化、两组运动及感觉功能ASIA评分。结果系统组下肢感觉及下肢运动恢复时间分别为(36.3±3.1)d、(54.6±7.3)d,显著早于被动组的(48.7±5.3)d、(86.7±9.5)d,两组比较差异有统计学意义(P<0.05)。系统组骨密度显著高于被动组[(0.69±0.3)mg/cm 3 vs.(-0.11±0.2)mg/cm 3],两组比较差异有统计学意义(P<0.05),降钙素水平高于对被动组[(7.51±0.21)μg/L vs.(5.11±0.12)μg/L],两组比较差异有统计学意义(P<0.05),系统组运动及感觉功能ASIA评分均显著高于被动组[(56.1±1.8)分vs.(30.3±1.3)分;(65.3±2.6)分vs.(35.9±1.6)分],两组比较差异有统计学意义(P<0.05)。结论对于腰椎爆裂骨折所致不完全性截瘫患者,系统运动康复训练不仅能有效促进患者下肢感觉及运动功能的恢复,同时可以改善骨密度。Objective To investigate the effect of systematic exercise rehabilitation training on postoperative spinal cord functional recovery in patients with incomplete lumbar spondylolisthesis.Methods Eighty cases of lumbar burst fracture in our hospital who were not completely paraplegic from May 2015 to Mar.2017 were divided into two groups according to random number method,with 40 cases in each group.The observation group was given systematic rehabilitation therapy and the control group was treated with passive exercise such as massage massage,traction acupuncture,hyperbaric oxygenation and electrical stimulation.All patients were followed up for 6 months.The sensory and recovery time of lower extremity,bone mineral density and bone calcitonin levels,and the motor and sensory function ASIA score were compared between the two groups after 6 months of intervention.Results After intervention,the feeling of lower extremities in the observation group and sensory recovery time of lumbar and leg were significantly earlier than those in the control group(P<0.05).The BMD of the observation group was significantly higher than that of the control group(P<0.05)after intervention.At 6 months after intervention,ASIA scores of motor and sensory function in observation group were significantly higher than those in control group(P<0.05).Conclusion For lumbar burst fracture patients with incomplete paraplegia,the implementation of effective comprehensive exercise rehabilitation training is of great significance to promote the recovery of lower extremity sensation and motor function,and to improve bone mineral density.

关 键 词：腰椎爆裂骨折 康复训练 不完全性截瘫 脊髓功能 

分 类 号：R683.2[医药卫生—骨科学]